2019-10-28T13:01:30-05:00 2018-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2018-01-01 133083068 COMMUNITY HEALTHCARE NETWORK COMM 2125452404 60 MADISON AVENUE NEW YORK NY 10010 ALAN WENGROFSKY CFO AND VP OF FINANCE 2125452404 2019-10-25 1 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2019-10-07 209.59.242.22 2019-10-25 12:31:33 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 238159564A7F207AC3E2D33505B4833284B8AC6F 2018 2019-02-21 02:37:17Z ROBERT HAYES 60 MADISON AVENUE NEW YORK NY 10010 103242814 0 X WWW.CHNNYC.ORG X 1978 NY COMMUNITY HEALTHCARE NETWORK, INC ("CHN") OPERATES FREESTANDING DIAGNOSTIC AND TREATMENT CENTERS, DESIGNATED AS A FEDERALLY QUALIFIED HEALTH CENTER, LICENSED UNDER ARTICLE 28 AND ARTICLE 31 OF THE NEW YORK STATE HEALTH LAW, LOCATED THOUGHOUT NEW YORK CITY. CHN PROVIDES A BROAD RANGE OF HEALTH SERVICES INCLUDING BUT NOT LIMITED TO PRIMARY AND PREVENTATIVE CARE, AND MENTAL HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION. 16 16 882 0 0 387992 24373719 25373481 71121775 65201213 1050982 1512987 2031609 1267087 98578085 93354768 0 0 0 0 57039402 56410351 0 0 0 38278758 37292195 95318160 93702546 3259925 -347778 95978296 91790210 17692247 16690124 78286049 75100086 CHN PROVIDES A BROAD RANGE OF HEALTH SERVICES INCLUDING BUT NOT LIMITED TO PRIMARY AND PREVENTATIVE CARE, AND MENTAL HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION. 0 0 82020145 66534685 CHN PROVIDES A BROAD RANGE OF HEALTH SERVICES INCLUDING BUT NOT LIMITED TO PRIMARY AND PREVENTATIVE CARE, AND MENTAL HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION. CHN PROVIDED HEALTH CARE SERVICES FOR 243,278 HEALTH CARE VISITS FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2018. 82020145 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 109 0 1 882 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X ALAN WENGROFSKY 2125452481 60 MADISON AVE NEW YORK NY 10010 BRENDA MERRITT BOARD MEMBER 1.00 X 0 0 0 CAROLINE DORSEN BOARD MEMBER 1.00 X 0 0 0 DENISE GORDON BOARD MEMBER 1.00 X 0 0 0 DONNA ANDERSON BOARD MEMBER 1.00 X 0 0 0 ELEANORA SOTTILARO SECRETARY 1.00 X X 0 0 0 ELIZABETH KELLNER CHAIRPERSON 1.00 X X 0 0 0 GRETA ELYSEE BOARD MEMBER 1.00 X 0 0 0 HARLEM J GUNNESS BOARD MEMBER 1.00 X 0 0 0 JOSEPHINE DIAZ BOARD MEMBER 1.00 X 0 0 0 JUNE NIKLUS VICE CHAIRPERSON 1.00 X X 0 0 0 KRISTIN MANZOLILLO BOARD MEMBER 1.00 X 0 0 0 NANCY RAPOPORT TREASURER 1.00 X X 0 0 0 PETER GEE BOARD MEMBER 1.00 X 0 0 0 RALPH AQUILA BOARD MEMBER 1.00 X 0 0 0 RANDY SILLER BOARD MEMBER 1.00 X 0 0 0 RONDA KOTELCHUCK BOARD MEMBER 1.00 X 0 0 0 ALAN WENGROFSKY CFO/VP FINANCE 35.00 X 292522 0 37874 KENNETH MEYER VP HUMAN RESOURCES 35.00 X 181798 0 34788 ROBERT HAYES PRESIDENT/CEO 35.00 X 416711 0 34850 MATTHEW WEISSMAN CHIEF MEDICAL OFFICER 35.00 X 252517 0 22316 DAVID GROSS LEGAL COUNSEL 35.00 X 218028 0 30638 GERTIE QUITANGON DIRECTOR OF PSYCHIATRY 35.00 X 238609 0 15033 JOSEPH SQUITIERI DEPUTY DIRECTOR OF PSYCHIATRY 35.00 X 224154 0 30476 KRISTEN MANTER CHIEF OF PRIMARY CARE 35.00 X 212040 0 31838 SHARON GRIFFITH MEDICAL DIRECTOR OF WOMENS SERVICES 35.00 X 226953 0 32200 2263332 0 270013 79 0 1 0 RELEVANT HEALTHCARE TECHNOLOGIES 222 BROADWAY 19TH FLOOR NEW YORK NY 10038 HEALTH HOME BILLING SERVICES 362217 COHNREZNICK LLP 1301 AVE OF THE AMERICAS NEW YORK NY 10019 ACCOUNTING & TAX 346855 FIDELUS TECHNOLOGIES LLC PO BOX 788852 PHILADELPHIA PA 19178 IT CONSULTANT 107426 3 189130 21016262 4168089 715548 25373481 MEDICAID & MEDICAID MANAGED CARE 623000 30787932 30787932 HEALTH HOME REVENUE 623000 20522630 20522630 340B PHARMACY 623000 4209399 4209399 NEW YORK STATE UNCOMPENSATED CARE 623000 2838951 2838951 PRIVARE INSURANCE 623000 2632859 2632859 4209442 4209442 65201213 97296 97296 11204977 9789286 1415691 1415691 1415691 32375 189130 98760 -66385 -66385 PATIENT REVENUE - INCENTIVE 900099 532029 532029 CCMP 900099 223745 223745 QARR HIV REVNUE 900099 46535 46535 531163 531163 1333472 93354768 66534685 0 1446602 1273376 1104712 168664 41788299 36253263 5535036 1102068 956094 145974 8605492 7465658 1139834 3641116 3158835 482281 78931 78931 382435 382435 78050 78050 218788 218788 3653880 3161563 492317 66441 66441 1794789 1395042 399747 3618640 2750166 868474 149140 129752 19388 321502 279707 41795 2268543 1724093 544450 232583 176763 55820 HEALTH HOME FEES 11824219 11824219 CONSUMABLE SUPPLIES 7303431 7144205 159226 BAD DEBTS 1641351 1641351 EQUIPMENT RENTAL 555444 422138 133306 3104028 2288093 815935 93702546 82020145 11682401 0 4029607 4240679 40638803 27297685 3647980 6062687 11702771 11695231 21402 403577 477409 36515293 26569632 8895801 9945661 24134517 29563596 1075440 1068685 1449800 1417175 95978296 91790210 10053043 10471688 6831505 4977343 807699 1241093 17692247 16690124 X 78286049 75100086 78286049 75100086 95978296 91790210 -347778 -2838185 0 X X 0 1 X 1 1 1 X 15982200 16600052 20404682 24373719 25373481 102734134 15982200 16600052 20404682 24373719 25373481 102734134 102734134 128164 622496 630463 1050982 97296 2529401 2645812 1007654 1148109 2104859 1365847 8272281 113535816 286295279 0.90490 0.89060 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: ADMIN FEES - 2014 AMOUNT: $ 267,672. CCMP REVENUE - 2014 AMOUNT: $ 170,986. 2015 AMOUNT: $ 195,691. 2016 AMOUNT: $ 564,315. 2017 AMOUNT: $ 160,557. 2018 AMOUNT: $ 223,745. EXPENSE WRITE OFF - 2014 AMOUNT: $ 150,000. FUNDRAISING REVENUE - 2015 AMOUNT: $ 61,600. 2016 AMOUNT: $ 14,200. 2017 AMOUNT: $ 30,360. 2018 AMOUNT: $ 32,375. HEALTH REVENUE - LIFE INSURANCE PROCEEDS - 2014 AMOUNT: $ 1,273,597. MEANINGFUL USE - 2014 AMOUNT: $ 556,750. 2015 AMOUNT: $ 391,000. 2017 AMOUNT: $ 663,000. MISCELLANEOUS INCOME - 2014 AMOUNT: $ 103,552. 2015 AMOUNT: $ 196,257. 2017 AMOUNT: $ 232,275. 2018 AMOUNT: $ 531,163. OTHER PATIENT REVENUE - 2016 AMOUNT: $ 498,566. 2017 AMOUNT: $ 437,770. 2018 AMOUNT: $ 532,029. QARR HIV REVENUE - 2015 AMOUNT: $ 90,021. 2016 AMOUNT: $ 25,355. 2017 AMOUNT: $ 580,897. QCCP REVENUE - 2014 AMOUNT: $ -36,877. 2015 AMOUNT: $ 73,085. 2016 AMOUNT: $ 45,673. 2018 AMOUNT: $ 46,535. QUALITY INCENTIVE - 2014 AMOUNT: $ 160,132. 0 1 0 0 0 0 1 78050 0 0 78050 0 PART II-B, LINE 1: THE LOBBYING ACTIVITIES INCLUDE RETENTION OF CONSULTANTS TO ADVISE CHN ON POLICY INITIATIVES AND ON OPPORTUNITIES TO SECURE SUPPORT FOR NEEDED COMMUNITY HEALTHCARE SERVICES INCLUDING A MOBILE OPTOMETRY CENTER AND ADDITIONAL CLINIC SPACE. 37931 37931 16460147 9855433 6604714 7863853 7110424 753429 9572390 7954773 1617617 2580972 1649002 931970 9945661 DEFERRED RENT 819910 DUE TO THIRD PARTY 421183 1241093 X 88755204 -2838185 -1641351 -4479536 93234740 218788 -98760 120028 93354768 91941167 98760 98760 91842407 218788 1641351 1860139 93702546 PART X, LINE 2: CHN HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2018. CHN'S FEDERAL AND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2015 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. CHN 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 DEBTS -1,641,351. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING DIRECT EXPENSES -98,760. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING DIRECT EXPENSES 98,760. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 1,641,351. GALA 221505 189130 32375 67804 1800 29156 221505 189130 32375 67804 1800 29156 98760 -66385 X 0 0 0 0 0 0 0 0 0 ALAN WENGROFSKY CFO/VP FINANCE 292246 0 0 0 276 0 0 0 37874 0 330396 0 0 0 KENNETH MEYER VP HUMAN RESOURCES 181282 0 0 0 516 0 0 0 34788 0 216586 0 0 0 ROBERT HAYES PRESIDENT/CEO 415187 0 0 0 1524 0 0 0 34850 0 451561 0 0 0 MATTHEW WEISSMAN CHIEF MEDICAL OFFICER 252437 0 0 0 80 0 0 0 22316 0 274833 0 0 0 DAVID GROSS LEGAL COUNSEL 217920 0 0 0 108 0 0 0 30638 0 248666 0 0 0 GERTIE QUITANGON DIRECTOR OF PSYCHIATRY 238333 0 0 0 276 0 0 0 15033 0 253642 0 0 0 JOSEPH SQUITIERI DEPUTY DIRECTOR OF PSYCHIATRY 224046 0 0 0 108 0 0 0 30476 0 254630 0 0 0 KRISTEN MANTER CHIEF OF PRIMARY CARE 211920 0 0 0 120 0 0 0 31838 0 243878 0 0 0 SHARON GRIFFITH MEDICAL DIRECTOR OF WOMENS SERVICES 226677 0 0 0 276 0 0 0 32200 0 259153 0 0 0 X 1 715548 COST 0 0 0 PART I, COLUMN (B): COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY INDEPENDENT ACCOUNTANT AND REVIEWED BY MANAGEMENT. IT IS THEN REVIEWED BY THE CHAIR OF THE BOARD AND THE FINANCE COMMITTEE AND DISTRIBUTED TO THE ENTIRE BOARD OF DIRECTORS BEFORE FILLING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL MANAGEMENT AND EMPLOYEES WHO ARE IN A POSITION TO INFLUENCE ANY SUBSTANTIVE BUSINESS DECISIONS SHALL, AT LEAST ANNUALLY, FILE A CONFLICT OF INTEREST DISCLOSURE STATEMENTS AND CONSULT WITH OUTSIDE COUNSEL, AS NECESSARY, CONCERNING ANY POTENTIAL PROBLEMS OR POSSIBLE CONFLICTS OF INTEREST. IN ADDITION, TO COMPLETING THE ANNUAL DISCLOSURE STATEMENT, ALL EMPLOYEES MUST ALSO IMMEDIATELY DISCLOSE TO THE COMPLIANCE OFFICER ANY POSSIBLE CONFLICTS OF INTEREST AS THEY ARISE. THE COMPLIANCE OFFICER, AS NECESSARY, WILL THEN CONSULT WITH OUTSIDE COUNSEL. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS DETERMINES AND APPROVES COMPENSATION OF THE CEO BASED ON RECOMENDATIONS FROM EXECUTIVE COMMITEE. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE SELECTION AND OVERSIGHT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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.