2020-02-10T08:41:26-06:00 2019-03-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2018-04-01 222682708 HENRY J AUSTIN HEALTH CENTER INC HENR 6092785900 321 N WARREN STREET TRENTON NJ 08618 JAMES T FOLEY CFO 6092785912 2020-02-04 1 KERRI N BOGDA CPA P00760402 7177404863 216.255.126.197 2020-02-04 09:27:20 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 45D50D8E3994CEF8BF8842BFE43A81B55B26F885 2018 2020-11-19 02:30:22Z KEMI ALLI MD 321 N WARREN STREET TRENTON NJ 08618 22733572 0 X WWW.HENRYJAUSTIN.ORG X 1986 NJ TO PROVIDE QUALITY HEALTHCARE TO MERCER COUNTY'S UNINSURED AND UNDERINSURED. 9 9 191 45 0 0 6974711 8757591 10832145 13917115 415 692 751795 58174 18559066 22733572 0 0 0 0 11087148 11655382 0 0 0 8297863 9723943 19385011 21379325 -825945 1354247 5676892 7574876 3845506 4389243 1831386 3185633 X THE HENRY J. AUSTIN HEALTH CENTER, INC. PROVIDES PATIENT-CENTERED, COMPREHENSIVE, ACCESSIBLE, EFFICIENT, QUALITY PRIMARY CARE SERVICES TO THE CULTURALLY DIVERSE GREATER TRENTON COMMUNITY. OUR EXCEPTIONAL, DEDICATED, WELL-TRAINED TEAM DELIVERS BEST PRACTICE HEALTH CARE, WORKING WITH COMMUNITY PARTNERS TO PROVIDE EXTRAORDINARY CUSTOMER SERVICE AND QUALITY OUTCOMES. 0 0 14343280 9205560 HENRY J. AUSTIN HEALTH CENTER PROVIDES MEDICAL, DENTAL, MENTAL AND OTHER HEALTH CARE SERVICES TO THE LARGELY MEDICALLY UNDERSERVED POPULATION OF THE SURROUNDING TRENTON AREA. DURING THE YEAR, THE ORGANIZATION SAW 17,959 PATIENTS AND HAD 73,497 PATIENT VISITS. THE AVERAGE NUMBER OF VISITS PER PATIENT WAS 4.09. 1579193 1696588 HENRY J. AUSTIN HEALTH CENTER PROVIDES MEDICAL, DENTAL, MENTAL AND OTHER HEALTH CARE SERVICES TO THE HOMELESS POPULATION IN THE SURROUNDING TRENTON AREA. DURING THE YEAR, THE ORGANIZATION SAW 751 PATIENTS AND HAD 4,459 PATIENT VISITS. THE AVERAGE NUMBER OF VISITS PER PATIENT WAS 5.94. 937912 1492527 HENRY J. AUSTIN HEALTH CENTER PROVIDES MEDICAL, DENTAL, MENTAL AND OTHER HEALTH CARE AND RELATED SUPPORTING SOCIAL SERVICES TO THE AFFECTED HIV POPULATION OF THE SURROUNDING TRENTON AREA. THESE SERVICES ALSO INCLUDE HIV EDUCATION AND PREVENTION SERVICES. DURING THE YEAR, THE ORGANIZATION SAW 431 PATIENTS AND HAD 6,355 PATIENT VISITS. THE AVERAGE NUMBER OF VISITS PER PATIENT WAS 14.74. 16860385 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 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 48 0 191 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ X JAMES T FOLEY CFO 6092785912 321 N WARREN STREET TRENTON NJ 08618 CHARLES DAVIS II CHAIRPERSON 1.50 0.00 X X 0 0 0 BEVERLY ANN SMITH VICE CHAIRPERSON 1.50 0.00 X X 0 0 0 DANIEL R BENSON BOARD TREASURER 1.50 0.00 X X 0 0 0 TYRONE GASKINS BOARD SECRETARY 1.50 0.00 X X 0 0 0 LAURENCE GANGES DIRECTOR 1.50 0.00 X 0 0 0 MARGE CALDWELL-WILSON DIRECTOR 1.50 0.00 X 0 0 0 DETRAVIUS BETHEA DIRECTOR 1.50 0.00 X 0 0 0 CHINWEZE AHAGHOTU DIRECTOR 1.50 0.00 X 0 0 0 DEKIA SMITH DIRECTOR 1.50 0.00 X 0 0 0 KEMI ALLI MD CEO 35.00 0.00 X 200817 0 28654 RACHAEL EVANS MD CMO 35.00 0.00 X 154869 0 23733 GABRIEL VONLEH COO TO 4/5/18 35.00 0.00 X 106425 0 16522 JAMES T FOLEY CFO AS OF 9/4/18 35.00 0.00 X 46576 0 286 ELIDORO PRIMERO CFO TO 6/4/18 35.00 0.00 X 59748 0 17051 MALA KAILASAM INTERNIST 40.00 0.00 X 202032 0 25228 MAGALI SANTOS DENTIST 40.00 0.00 X 150519 0 35643 DEVIN GOODMAN DDS DIRECTOR OF DENTISTRY 40.00 0.00 X 148538 0 3419 SPRING MATTHEWS-BROWN INTERNIST 40.00 0.00 X 143479 0 0 SHAUNON MOTEN DENTIST 40.00 0.00 X 141910 0 19932 1354913 0 170468 21 0 1 0 ABW MEDICAL LLC PO BOX 882141 PORT ST LUCIE FL 34988 BILLING AND EMR SPECIALISTS 365581 ATHENAHEALTH INC PO BOX 415615 BOSTON MA 02241 EMR SYSTEMS SUPPORT AND TRAINING 231036 SCRIBE AMERICA LLC PO BOX 417756 BOSTON MA 02241 MEDICAL SCRIBES 227325 SCOZZARI BUILDERS INC 1891 NORTH OLDEN AVENUE TRENTON NJ 08638 BUILDING CONSTRUCTION 201544 THE COLLEGE OF NEW JERSEY TRENTON HALL 206 EWING NJ 08628 STUDENT NURSING SERVICES 129065 10 6851704 1905887 1265683 8757591 PATIENT SERVICE REVENUE 621400 11818037 11818037 340B PROGRAM 621400 1573102 1573102 CONTRACT SERVICES 900099 451335 451335 THIRD PARTY INCENTIVES 621400 74641 74641 13917115 692 692 REFUNDS AND INCENTIVES 900099 30777 30777 MEDICAL RECORDS SUBPOENA FEES 900099 25900 25900 QI PARTICIPATION FEES 900099 1497 1497 58174 22733572 13917115 0 58866 715563 715563 8923321 7723872 1199449 1352584 1126646 225938 663914 519210 144704 319589 248240 71349 217732 217732 1952861 953320 999541 3418 3418 395176 90155 305021 88483 68729 19754 135148 1404 133744 14577 10468 4109 131019 50625 80394 93375 93375 384940 384940 91104 3018 88086 MEDICAL SUPPLIES 3040747 3040747 BAD DEBT EXPENSE 2207067 2207067 EQUIPMENT & REPAIRS 211687 89072 122615 LICENSES & FEES 172665 134117 38548 264355 205337 59018 21379325 16860385 4518940 0 2680 2680 124288 1028476 304212 357069 1202847 1042348 98361 71495 8807444 4212523 3557199 4594921 387305 477887 5676892 7574876 2601332 2605499 176820 333216 1067354 931335 0 519193 3845506 4389243 X 1831386 2935633 250000 1831386 3185633 5676892 7574876 1354247 0 X 0 1 X 1 1 1 X 5908790 6288520 6878381 6974711 8757591 34807993 8296475 7893813 8300451 11563734 13917115 49971588 14205265 14182333 15178832 18538445 22674706 84779581 0 0 0 84779581 31185 16952 10874 13466 692 73169 31185 16952 10874 13466 692 73169 25458 11296 25259 58174 120187 14236450 14224743 15201002 18577170 22733572 84972937 0.99770 0.98500 0.00090 0.00150 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2015 AMOUNT: $ 20,918. GAIN ON EXTINGUISHMENT OF DEBT - 2015 AMOUNT: $ 4,540. MEDICAL RECORDS SUBPOENA FEES - 2016 AMOUNT: $ 2,030. 2017 AMOUNT: $ 20,738. 2018 AMOUNT: $ 25,900. QI PARTICIPATION FEES - 2016 AMOUNT: $ 510. 2017 AMOUNT: $ 4,022. 2018 AMOUNT: $ 1,497. REFUNDS AND INCENTIVES - 2016 AMOUNT: $ 8,756. 2017 AMOUNT: $ 499. 2018 AMOUNT: $ 30,777. ADMINISTRATIVE FEES - RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 102342 102342 4355672 1459759 2895913 2682937 1311989 1370948 1666295 1440744 225551 198 31 167 4594921 PHARMACY STOCK 477887 477887 OTHER LIABILITIES 519193 519193 X 21595588 0 21595588 1137984 1137984 22733572 20241341 0 20241341 1137984 1137984 21379325 PART X, LINE 2: THE CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF 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 IN 2019 AND 2018. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR DOUBTFUL ACCOUNTS 1,137,984. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR DOUBTFUL ACCOUNTS 1,137,984. X X X 0 0 0 0 0 0 0 0 0 KEMI ALLI MD CEO 200817 0 0 0 0 0 12154 0 16500 0 229471 0 0 0 RACHAEL EVANS MD CMO 154869 0 0 0 0 0 23733 0 0 0 178602 0 0 0 MALA KAILASAM INTERNIST 202032 0 0 0 0 0 728 0 24500 0 227260 0 0 0 MAGALI SANTOS DENTIST 150519 0 0 0 0 0 11143 0 24500 0 186162 0 0 0 DEVIN GOODMAN DDS DIRECTOR OF DENTISTRY 148538 0 0 0 0 0 3419 0 0 0 151957 0 0 0 SHAUNON MOTEN DENTIST 141910 0 0 0 0 0 10333 0 9599 0 161842 0 0 0 X 1 446600 FMV X 14730 819083 COST 0 0 1 0 PART I, COLUMN (B): THE NUMBER IN COLUMN B OF PART I REPRESENTS THE NUMBER OF ITEMS DONATED. FORM 990, PART VI, SECTION A, LINE 1 IN EMERGENCY SITUATIONS WHERE THE FULL BOARD IS UNAVAILABLE, THE EXECUTIVE COMMITTEE, MADE UP OF THE CHAIRPERSON OF EACH COMMITTEE, MAY ACT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED IN DETAIL BY THE CFO OF THE ORGANIZATION, WHO HAS NEARLY 20 YEARS OF EXPERIENCE WITH NOT FOR PROFIT ORGANIZATIONS. THE FORM 990 IS THEN GIVEN TO THE FINANCE COMMITTEE FOR THEIR REVIEW AND APPROVAL. THE FINANCE COMMITTEE PERFORMS THE ULTIMATE SIGN OFF ON THE FORM 990. AFTER THE RETURN IS APPROVED INTERNALLY AND PRIOR TO FILING, A COPY IS GIVEN TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR THEIR REVIEW AND THE MEMBERS ARE GIVEN AN OPPORTUNITY TO ASK QUESTIONS REGARDING THE FORM 990. ONCE THIS PROCEDURE IS COMPLETED, THE FORM 990 IS SIGNED BY THE CFO AND FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, THE ORGANIZATION DISTRIBUTES A CONFLICT OF INTEREST POLICY STATEMENT TO EXECUTIVE MANAGEMENT AND THE BOARD OF DIRECTORS FOR THEIR REVIEW AND AFFIRMATIVE ACKNOWLEDGEMENT THAT THEY ARE AWARE OF THE POLICY. THE CEO'S EXECUTIVE ASSISTANT REVIEWS AND MONITORS COMPLIANCE WITH THE CONFLICT STATEMENTS. IN ADDITION, THE ORGANIZATION ASKS FOR INFORMATION REGARDING ANY ORGANIZATION(S) THAT SENIOR MANAGEMENT, MEDICAL STAFF OR BOARD OF DIRECTORS HAVE AN INTEREST IN TO ENSURE THAT REFERRALS OR OTHER VENDOR RELATIONSHIPS ARE NOT BEING CONSUMMATED WITH THOSE ENTITIES. ANY POTENTIAL CONFLICTS OF INTEREST ARE BROUGHT TO A SUBSET OF THE BOARD OF DIRECTORS FOR THEIR INITIAL REVIEW. ANY CONFLICTS DEEMED BY THIS SUBSET TO BE POTENTIALLY DETRIMENTAL TO THE ORGANIZATION ARE REFERRED TO LEGAL COUNSEL FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 15 THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) ISSUES AN ANNUAL SALARY SURVEY, AS DOES THE NEW JERSEY PRIMARY CARE ASSOCIATION (NJPCA). SUCH INFORMATION HAS BEEN PROVIDED TO THE BOARD FOR USE IN DETERMINING THE SALARY FOR THE CURRENT CEO WHO WAS HIRED IN MAY 2015 AND OTHER TOP MANAGEMENT POSITIONS (COO AND CFO) HIRED IN 2019 AND 2018, RESPECTIVELY. THE CEO, CFO AND COO ALSO USE THE INFORMATION FOR HIRING SENIOR STAFF MEMBERS. DISCUSSIONS BY THE BOARD REGARDING COMPENSATION DETERMINATION ARE DOCUMENTED IN THE BOARD MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.