MONMOUTH FAMILY HEALTH CENTER INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- MONMOUTH FAMILY HEALTH CENTER INC (EIN 20-0547132)
- Tax period
- 2018-04-01 to 2019-03-31
- Filed
- 2020-02-13
- IRS object ID
- 202030449349301853
- Schema version
- 2018v3.1
- 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 | 2020-02-13T14:38:32-06:00 | ReturnTs |
| Tax Period End | 2019-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1570 FRUITVILLE PIKE SUITE 400 | AddressLine1Txt |
| City | LANCASTER | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200547132 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONMOUTH FAMILY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MONM | BusinessNameControlTxt |
| Phone | 7329630159 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 270 BROADWAY | AddressLine1Txt |
| City | LONG BRANCH | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07740 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT J AURIEMMA | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7329630159 | PhoneNum |
| Signature | 2020-02-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KERRI N BOGDA CPA | PreparerPersonNm |
| PTIN | P00760402 | PTIN |
| Phone | 7177404863 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 96.89.178.154 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-02-11 | IPDt |
| IP Tm | 16:05:44 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | AE0C272A69DD34E2EDF3B6A185DE1CF90EACE8A4 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT J AURIEMMA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 270 BROADWAY | AddressLine1Txt |
| City | LONG BRANCH | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07740 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,620,853 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MFHCNJ.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | NJ | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE A BROAD RANGE OF HEALTH SERVICES TO THE MEDICALLY UNDERSERVED POPULATION IN MONMOUTH COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 109 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,645,020 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,690,304 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,241,943 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,901,518 | CYProgramServiceRevenueAmt |
| PY Investment Income | $18,640 | PYInvestmentIncomeAmt |
| CY Investment Income | $21,507 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,611 | PYOtherRevenueAmt |
| CY Other Revenue | $7,524 | CYOtherRevenueAmt |
| PY Total Revenue | $9,912,214 | PYTotalRevenueAmt |
| CY Total Revenue | $9,620,853 | 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 | $5,133,344 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,194,381 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,954,931 | PYOtherExpensesAmt |
| CY Other Expenses | $4,659,541 | CYOtherExpensesAmt |
| PY Total Expenses | $10,088,275 | PYTotalExpensesAmt |
| CY Total Expenses | $9,853,922 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$176,061 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$233,069 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,085,173 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,858,755 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,213,315 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,219,517 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,871,858 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,639,238 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE MEDICAL, DENTAL, AND OTHER SOCIAL SERVICES TO THE UNDERSERVED POPULATION OF MONMOUTH COUNTY, NEW JERSEY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,863,741 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,901,518 | RevenueAmt |
| Desc | FOR THE FISCAL YEAR ENDED 3/31/2019, THE CENTER PROVIDED OUTPATIENT HEALTHCARE SERVICES TO APPROXIMATELY 14,000 PATIENTS, TOTALING APPROXIMATELY 50,000 VISITS. SERVICES INCLUDED OBSTETRICS / GYNECOLOGY, MEDICINE, PEDIATRICS, BEHAVIORAL HEALTH SERVICES, DENTAL, PODIATRY AND HIV. THE CENTER CONTINUES TO PROVIDE COMMUNITY IN-REACH, OUTREACH AND ENROLLMENT ASSISTANCE IN ORDER TO MEET ANTICIPATED INCREASES IN PATIENT AND SERVICE AREA NEEDS.THE CENTER IS OPEN TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE CENTER PROVIDES CHARITY CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER A SLIDING FEE DISCOUNT POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. COMMUNITY BENEFIT REPRESENTS THE COST OF SERVICES FOR MEDICAID, MEDICARE, AND OTHER PUBLIC PATIENTS FOR WHICH THE CENTER IS NOT REIMBURSED. CHARITY CARE AND COMMUNITY BENEFIT PROVIDED TO PATIENTS DURING THE FISCAL YEAR ENDED 3/31/2019 APPROXIMATED $1,172,000 AND $1,432,000, RESPECTIVELY. | Desc |
| Total Program Service Expenses | $7,863,741 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | 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 | 39 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 109 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NJ | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBERT J AURIEMMA CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7329630159 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 80 PAVILION AVE | AddressLine1Txt |
| City | LONG BRANCH | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07740 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 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 |
|---|---|---|---|---|---|---|---|---|
| KATHLEEN BILLINGS | ||||||||
| CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DEBRA BRADLEY | ||||||||
| VICE CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WEBSTER TRAMMELL PSY D | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ERIC CARNEY | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RODNEY O'NEAL | ||||||||
| TREASURER (UNTIL 07/2018) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DIANA TENNANT | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARJORIE BAFATY | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOYCE QUARLES | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOAN WILLS | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFFREY LEDERMAN MD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CARL JENNINGS | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANDRES MEJER | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARTA C SILVERBERG | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $192,317 | $0 | $28,626 | |||
| ROBERT J AURIEMMA | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $120,982 | $0 | $27,884 | |||
| RAKSHA JOSHI MD | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | $291,128 | $0 | $31,259 | Yes (X) | |||
| DR MARIELA KAPOOR | ||||||||
| PHYSICIAN | 36.00 | $216,646 | $0 | $38,288 | Yes (X) | |||
| AAREFA SHAKIR MD | ||||||||
| PHYSICIAN | 24.00 | $143,334 | $0 | $4,480 | Yes (X) | |||
| TITHI MITRA MD | ||||||||
| PHYSICIAN | 24.00 | $112,439 | $0 | $3,373 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,076,846 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $133,910 | 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 |
|---|---|---|---|---|---|
| MONMOUTH MEDICAL CENTER | |||||
| 300 2ND AVENUE | LONG BRANCH | NJ | 07740 | RESIDENT SERVICES | $984,649 |
| STERICYCLE INC | |||||
| 4010 COMMERCIAL AVENUE | NORTHBROOK | IL | 60062 | MEDICAL WASTE REMOVAL SERVICES | $117,862 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,768,995 | GovernmentGrantsAmt |
| All Other Contributions | $921,309 | AllOtherContributionsAmt |
| Noncash Contributions | $518,309 | NoncashContributionsAmt |
| Total Contributions | $2,690,304 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID | 621990 | $3,761,253 | $3,761,253 |
| NJ UNCOMPENSATED | 621990 | $1,379,088 | $1,379,088 |
| SELF PAY | 621990 | $911,620 | $911,620 |
| 340B PROGRAM | 621990 | $565,715 | $565,715 |
| MEDICARE | 621990 | $283,842 | $283,842 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,901,518 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,507 | TotalRevenueColumnAmt |
| Exclusion | $21,507 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL RECORDS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $7,410 | TotalRevenueColumnAmt |
| Exclusion | $7,410 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $114 | TotalRevenueColumnAmt |
| Exclusion | $114 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,524 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,620,853 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,901,518 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $29,031 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $685,660 | TotalAmt |
| Program Services | $480,665 | ProgramServicesAmt |
| Management And General | $204,995 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,456,916 | TotalAmt |
| Program Services | $2,592,687 | ProgramServicesAmt |
| Management And General | $864,229 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,039 | TotalAmt |
| Program Services | $74,336 | ProgramServicesAmt |
| Management And General | $31,703 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $546,859 | TotalAmt |
| Program Services | $414,830 | ProgramServicesAmt |
| Management And General | $132,029 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $398,907 | TotalAmt |
| Program Services | $279,644 | ProgramServicesAmt |
| Management And General | $119,263 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,370 | TotalAmt |
| Program Services | $4,386 | ProgramServicesAmt |
| Management And General | $2,984 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,347 | TotalAmt |
| Program Services | $32,941 | ProgramServicesAmt |
| Management And General | $22,406 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,759,160 | TotalAmt |
| Program Services | $1,488,828 | ProgramServicesAmt |
| Management And General | $270,332 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,967 | TotalAmt |
| Program Services | $132,286 | ProgramServicesAmt |
| Management And General | $28,681 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $516,712 | TotalAmt |
| Program Services | $385,777 | ProgramServicesAmt |
| Management And General | $130,935 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,077 | TotalAmt |
| Program Services | $9,220 | ProgramServicesAmt |
| Management And General | $2,857 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,213 | TotalAmt |
| Program Services | $6,270 | ProgramServicesAmt |
| Management And General | $1,943 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $531,642 | TotalAmt |
| Program Services | $425,314 | ProgramServicesAmt |
| Management And General | $106,328 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,944 | TotalAmt |
| Program Services | $58,303 | ProgramServicesAmt |
| Management And General | $12,641 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACY SUPPLIES | $753,725 | $753,725 | |
| REPAIRS & MAINTENANCE | $184,756 | $151,837 | $32,919 |
| DENTAL SUPPLIES | $154,133 | $154,133 | |
| BAD DEBT EXPENSE | $150,000 | $150,000 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,495 | TotalAmt |
| Program Services | $268,559 | ProgramServicesAmt |
| Management And General | $25,936 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,853,922 | TotalAmt |
| Program Services | $7,863,741 | ProgramServicesAmt |
| Management And General | $1,990,181 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $379,793 | BOYAmt |
| EOY | $91,405 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,016,494 | BOYAmt |
| EOY | $2,267,564 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,571,136 | BOYAmt |
| EOY | $2,803,218 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $123,277 | BOYAmt |
| EOY | $128,810 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,691,368 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,779,665 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,358,052 | BOYAmt |
| EOY | $1,911,703 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $592,321 | BOYAmt |
| EOY | $611,955 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,100 | BOYAmt |
| EOY | $44,100 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,085,173 | BOYAmt |
| EOY | $7,858,755 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,113,065 | BOYAmt |
| EOY | $1,127,704 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,250 | BOYAmt |
| EOY | $91,813 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,213,315 | BOYAmt |
| EOY | $1,219,517 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,871,858 | BOYAmt |
| EOY | $6,639,238 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,871,858 | BOYAmt |
| EOY | $6,639,238 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,085,173 | BOYAmt |
| EOY | $7,858,755 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$233,069 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $449 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 | $3,701,479 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,276,298 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,454,527 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,645,020 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,690,304 | CurrentTaxYearAmt |
| Total | $13,767,628 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,701,479 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,276,298 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,454,527 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,645,020 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,690,304 | CurrentTaxYearAmt |
| Total | $13,767,628 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $3,840,134 | SubstantialContributorsTotAmt |
| Public Support Total170 | $9,927,494 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,730 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,491 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,175 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,640 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,507 | CurrentTaxYearAmt |
| Total | $71,543 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $10,132 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,555 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,611 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,524 | CurrentTaxYearAmt |
| Total | $31,822 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $13,870,993 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $34,751,502 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.71570 | PublicSupportCY170Pct |
| Public Support PY170 | 0.73980 | 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 | OTHER REVENUE - 2015 AMOUNT: $ 4,038. 2016 AMOUNT: $ 6. 2017 AMOUNT: $ 250. 2018 AMOUNT: $ 114. MEDICAL RECORDS - 2015 AMOUNT: $ 6,094. 2016 AMOUNT: $ 7,549. 2017 AMOUNT: $ 6,361. 2018 AMOUNT: $ 7,410. | 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
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $101,654 | OtherCostOrOtherBasisAmt |
| Depreciation | $47,204 | DepreciationAmt |
| Book Value | $54,450 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,970,999 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,306,389 | DepreciationAmt |
| Book Value | $1,664,610 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,618,715 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,426,072 | DepreciationAmt |
| Book Value | $192,643 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,911,703 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,471,302 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $449 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$150,000 | OtherRevenueAmt |
| Revenue Not Reported | -$149,551 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,620,853 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,620,853 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,703,922 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,703,922 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $150,000 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $150,000 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,853,922 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OR MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD FOR 2019 AND 2018. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIALS -150,000. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIALS 150,000. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | 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 | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARTA C SILVERBERG | ||||||||||||||
| EXECUTIVE DIRECTOR | $192,317 | $0 | $0 | $0 | $0 | $0 | $5,884 | $0 | $22,742 | $0 | $220,943 | $0 | $0 | $0 |
| RAKSHA JOSHI MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $291,128 | $0 | $0 | $0 | $0 | $0 | $8,297 | $0 | $22,962 | $0 | $322,387 | $0 | $0 | $0 |
| DR MARIELA KAPOOR | ||||||||||||||
| PHYSICIAN | $216,646 | $0 | $0 | $0 | $0 | $0 | $6,712 | $0 | $31,576 | $0 | $254,934 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $518,309 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | CURRENT SALES PRICE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | NUMBER OF CONTRIBUTIONS IN PART I, COLUMN B REPRESENTS THE TOTAL NUMBER OF CONTRIBUTORS FOR THAT PARTICULAR ITEM. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION PROVIDES THE BOARD OF TRUSTEES WITH AN ELECTRONIC COPY OF THE FORM 990 IN ADVANCE OF FILING WITH THE IRS. PRIOR TO FILING, THE TAX PREPARER IS AVAILABLE TO ANSWER ALL QUESTIONS THAT ANY MEMBER OF THE BOARD OF TRUSTEES MAY HAVE. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANY DIRECTOR, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, THROUGH BUSINESS, INVESTMENT, OR FAMILY IN AN ENTITY OR INDIVIDUAL WITH WHICH THE CORPORATION HAS A TRANSACTION OR ARRANGEMENT MUST COMPLETE A CONFLICT OF INTEREST STATEMENT. IN ADDITION, IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS. DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS MONITOR THE CONFLICT OF INTEREST POLICY ON A REGULAR BASIS. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE INTERESTED PERSON MAY NOT PARTICIPATE IN THE DISCUSSION OF, OR VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTED IN THE CONFLICT OF INTEREST. MANAGEMENT WILL DETERMINE IF THE CONFLICT IS OF A NATURE THAT MUST BE REFERRED TO LEGAL COUNSEL FOR RECOMMENDATION AS TO THE APPROPRIATE ACTION TO BE TAKEN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE CEO IS DETERMINED VIA INDEPENDENT COMPENSATION SURVEYS, INCLUDING THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE NEW JERSEY PRIMARY CARE ASSOCIATION, TO ENSURE THAT TOTAL ANNUAL COMPENSATION IS COMPARABLE AND DOES NOT EXCEED THE FAIR MARKET VALUE OF CEO POSITIONS IN SIMILAR FEDERALLY QUALIFIED HEALTH CENTERS (FQHC'S) WITHIN THE STATE. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD. ADDITIONALLY, THE PROCESS FOR DETERMINING THE CEO'S COMPENSATION IS DOCUMENTED IN THE BOARD MEETING MINUTES. THE PROCESS FOR DETERMINING OTHER EMPLOYEE COMPENSATION IS NOT DOCUMENTED IN THE BOARD MEETING MINUTES. THE COMPENSATION OF THE CFO AND CMO IS DETERMINED VIA INDEPENDENT COMPENSATION SURVEYS, INCLUDING THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE NEW JERSEY PRIMARY CARE ASSOCIATION, TO ENSURE THAT TOTAL ANNUAL COMPENSATION IS COMPARABLE AND DOES NOT EXCEED THE FAIR MARKET VALUE OF THESE POSITIONS IN SIMILAR FQHC'S WITHIN THE STATE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION WILL PROVIDE ALL GOVERNING DOCUMENTS TO ANY PERSON(S) WHO REQUEST THE DOCUMENTS EITHER IN WRITING OR IN PERSON. UPON THE REQUEST, THE ORGANIZATION LOGS WHAT WAS REQUESTED, BY WHOM, AND WHERE AND WHEN THE DOCUMENTS WERE SENT. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 936,649. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 936,649. DENTIST FEES: PROGRAM SERVICE EXPENSES 62,865. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,865. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 164,267. MANAGEMENT AND GENERAL EXPENSES 111,730. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 275,997. MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 71,952. MANAGEMENT AND GENERAL EXPENSES 48,939. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 120,891. LABORATORY FEES: PROGRAM SERVICE EXPENSES 91,866. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,866. DATA PROCESSING: PROGRAM SERVICE EXPENSES 161,229. MANAGEMENT AND GENERAL EXPENSES 109,663. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 270,892. |