2018-11-14T17:30:12-06:00 2017-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2017-01-01 132707945 BRONXCARE DR MARTIN LUTHER KING JR HEALTH CENTER INC BRON 7189018600 1265 FRANKLIN AVENUE BRONX NY 10456 VICTOR DEMARCO SENIOR VICE PRESIDENT & CFO 7189018600 2018-11-14 1 AARON SHAPIRO P01333816 2128674000 64.22.227.161 2018-11-14 12:33:10 ES P 4275C7E7C8129915C35F764424C97B97C01C68F2 988419C5643A1C0877F6823E03E3852E0B43B763 2017 2019-02-21 02:37:17Z VICTOR G DEMARCO 1265 FRANKLIN AVENUE BRONX NY 10456 52861828 0 X N/A X 1968 NY TO PROVIDE A BROAD RANGE OF HEALTH SERVICES TO A POPULATION THAT IS LARGELY ECONOMICALLY DEPRIVED. 11 10 369 10 0 0 2657720 4105277 44415171 48696034 0 0 71691 60517 47144582 52861828 0 0 0 0 27765432 28582936 0 0 0 15637064 15181660 43402496 43764596 3742086 9097232 15148579 21627778 34494511 31876478 -19345932 -10248700 X TO DELIVER COMPREHENSIVE, QUALITY AND EFFICIENT PRIMARY AND AMBULATORY HEALTH CARE SERVICES TO ADDRESS THE HEALTH CARE NEEDS OF THE RESIDENTS OF THE SOUTH AND CENTRAL BRONX, AND OF ALL THE OTHER COMMUNITIES WE SERVE, AND TO ENHANCE THE REPUTATION OF THE HEALTH CENTER AS ONE OF THE PREMIER COMMUNITY HEALTH CENTERS IN THE BRONX AND NEW YORK CITY. 0 0 36372082 48696034 DR. MARTIN LUTHER KING JR. HEALTH CENTER, INC. IS A FREE STANDING AMBULATORY CARE FACILITY. THE CENTER PROVIDES VARIOUS DIAGNOSTIC AND TREATMENT SERVICES TO ITS COMMUNITY. 36372082 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 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 1 0 0 0 1 0 0 369 1 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X VICTOR DEMARCO 7189018600 1265 FRANKLIN AVENUE BRONX NY 10456 MR MIGUEL A FUENTES JR PRESIDENT & CEO 1.00 44.00 X X 0 2009807 57315 MR VAUGHN THOMAS CHAIRPERSON 4.00 X X 0 0 0 MR JULIO PABON MPA VICE CHAIRPERSON 3.00 X X 0 0 0 MR ROBERT CARRILLO TREASURER 3.00 X X 0 0 0 MS CLAUDIA NISBETT SECRETARY 3.00 X X 0 0 0 MR WINSTON BREWSTER BOARD MEMBER 2.00 X 0 0 0 PROF ELLEN R HOIST MS RN BOARD MEMBER 2.00 X 0 0 0 MR LUIS MOJICA EDD BOARD MEMBER 2.00 X 0 0 0 MS MARTHA REYES RN BOARD MEMBER 2.00 X 0 0 0 MS NEVA SHILLINGFORD BOARD MEMBER 2.00 X 0 0 0 PROF SIGMUND C SHIPP PH D BOARD MEMBER 2.00 X 0 0 0 MR VICTOR G DEMARCO SENIOR VICE PRESIDENT & CFO 1.00 44.00 X 0 898409 47848 MR LIONEL STEWART EXECUTIVE DIRECTOR 40.00 X 188107 0 15071 DR AYILAM SUDHAKAR MD PHYSICIAN- MEDICINE 40.00 X 389248 0 23319 DR AMPARO RAMIREZ MD PHYSICIAN- MEDICINE 40.00 X 271405 0 46229 DR JOSE TIBURCIO MD PHYSICIAN-PSYCHIATRY 40.00 X 342233 0 23994 DR PAYAL PATEL MD PHYSICIAN- MEDICINE 40.00 X 398313 0 6861 DR SHARON KIM MD CHIEF OF SERVICE INTERNAL MEDICINE 40.00 X 376641 0 37089 1965947 2908216 257726 61 0 1 0 IHEALTH HOLDINGS LLC 462 SOUTH 4TH STREET SUITE 1810 LOUISVILLE KY 40202 BILLING 342205 JZANUS LTD 170 JERICHO TURNPIKE FLORAL PARK NY 11001 BILLING 187227 AETNA US HEALTHCARE PO BOX 88863 CHICAGO IL 60695 HEALTHCARE 146717 RCM TECHNOLOGIES P O BOX 536342 PITTSBURGH PA 15253 NURSING CONTRACT 120577 4 2663217 1442060 724135 4105277 PATIENT REVENUE 621400 48696034 48696034 48696034 TRAVEL REIMBURSEMENT 900099 57922 57922 MEDICAL RECORDS FEE 900099 2595 2595 60517 52861828 48696034 0 60517 203178 28445 174733 20289133 16311382 3977751 1661591 1474392 187199 4646388 3798677 847711 1782646 1568728 213918 38670 38670 25295 25295 3823866 3365002 458864 4680494 4290905 389589 955254 840624 114630 4178122 3467841 710281 86110 75777 10333 36107 36107 885196 734713 150483 358402 315394 43008 114144 100202 13942 43764596 36372082 7392514 0 5538469 14599863 120171 120171 3170995 3140582 42101 45073 19836377 16947188 3310210 2889189 2966633 832900 15148579 21627778 4548391 4760621 29946120 27115857 34494511 31876478 X -19345932 -10248700 -19345932 -10248700 15148579 21627778 9097232 0 X X 0 1 X 1 1 1 X 2414004 1975503 2426749 2657720 4105277 13579253 40271085 42330208 44046547 44415171 48696034 219759045 42685089 44305711 46473296 47072891 52801311 233338298 0 0 0 233338298 102902 116025 105577 71691 60517 456712 42787991 44421736 46578873 47144582 52861828 233795010 0.99800 0.99780 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: PARKING LOT TRAVEL REIMBURSEMENT MEDICAL RECORDS FEE 9597735 7995114 1602621 10238642 8952074 1286568 2889189 DUE TO THE BRONX-LEBANON HOSPITAL CENTER 25352472 DUE TO THIRD PARTIES 1763385 27115857 X 52861828 0 52861828 0 52861828 43764596 0 43764596 0 43764596 PART X, LINE 2: DR. MARTIN LUTHER KING, JR. HEALTH CENTER, INC. HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2014 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. 0 1 0 0 0 0 0 1 0 MR MIGUEL A FUENTES JR PRESIDENT & CEO 0 1256091 0 732994 0 20722 0 32779 0 24536 0 2067122 0 0 MR VICTOR G DEMARCO SENIOR VICE PRESIDENT & CFO 0 676133 0 199920 0 22356 0 23117 0 24731 0 946257 0 0 MR LIONEL STEWART EXECUTIVE DIRECTOR 186253 0 0 0 1854 0 13855 0 1216 0 203178 0 0 0 DR AYILAM SUDHAKAR MD PHYSICIAN- MEDICINE 161833 0 208899 0 18516 0 23117 0 202 0 412567 0 0 0 DR AMPARO RAMIREZ MD PHYSICIAN- MEDICINE 159140 0 111749 0 516 0 23117 0 23112 0 317634 0 0 0 DR JOSE TIBURCIO MD PHYSICIAN-PSYCHIATRY 229378 0 102275 0 10580 0 23117 0 877 0 366227 0 0 0 DR PAYAL PATEL MD PHYSICIAN- MEDICINE 398217 0 0 0 96 0 6852 0 9 0 405174 0 0 0 DR SHARON KIM MD CHIEF OF SERVICE INTERNAL MEDICINE 128647 0 247892 0 102 0 9247 0 27842 0 413730 0 0 0 PART I, LINE 3 BRONX-LEBANON HOSPITAL CENTER (BLHC), A RELATED ENTITY, USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE THE SALARY OF THE PRESIDENT & CEO,AND THE SENIOR VICE PRESIDENT & CFO. PART I, LINE 4B BLHC CONTRIBUTED $18,000 TO THE SENIOR VICE PRESIDENT & CFO'S NON-QUALIFIED RETIREMENT PLAN AND $10,400 TO JOSE TIBURCIO. PART I, LINE 7 MR. LIONEL STEWART, PAYAL PATEL, MD, AYILAM SUDHAKAR, MD, JOSE TIBURCIO, MD, AMPARO RAMIREZ, MD, AND SHARON KIM, MD WERE AWARDED A BONUS FOR ACHIEVEMENT OF GOALS SET FORTH IN THE BEGINING OF THE YEAR BY MANAGEMENT. PART II, PRESIDENT AND CEO LINE (II) INCLUDED IN COLUMN B (II), IS 732,995 REPRESENTING AN ANNUAL BONUS IN RECOGNITION OF THE SIGNIFICANT CONTRIBUTIONS MADE BY PRESIDENT AND CEO IN 2017. THIS BONUS IS BASED ON HIS SUCCESS IN ACHIEVING SPECIFIC TARGETS RELATED TO THE HOSPITAL'S OPERATING PROFIT, CONTROL OF GROWTH IN PAYROLL AND MEDICAL QUALITY PERFORMANCE. X 1 724135 COST 0 0 0 PART I, COLUMN (B): DR. MARTIN LUTHER KING, JR. HEALTH CENTER, INC. IS REPORTING THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY MANAGEMENT AND THEN IS DISTRIBUTED TO THE ENTIRE BOARD OF DIRECTORS FOR REVIEW AT THE NEXT BOARD MEETING BEFORE THE SUBMISSION OF THE FORM 990 TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL PERSONS ARE COVERED UNDER THE POLICY. THE INTERNAL AUDITOR REVIEWS CONFLICT OF INTEREST STATEMENTS AND INVESTIGATES POTENTIAL CONFLICTS. LEGAL OPINIONS ARE SOUGHT WHEN NECESSARY. PERSONS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISIONS IN RELATED TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15A BLHC, A RELATED PARTY TO DR. MARTIN LUTHER KING, JR. HEALTH CENTER, INC., HAS A PROCESS FOR DETERMINING COMPENSATION OF OFFICERS. ALL ELEMENTS OF COMPENSATION AND BENEFITS PROVIDED TO EACH OFFICER ARE REVIEWED AND APPROVED IN ADVANCE BY THE COMPENSATION COMMITTEE (COMMITTEE) OF THE BOARD OF TRUSTEES, AND THIS REVIEW AND APPROVAL PROCESS IS CONDUCTED IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF FEDERAL INCOME TAX LAW. THE COMMITTEE CONSISTS OF THREE INDEPENDENT MEMBERS OF THE BOARD. THEY RECEIVE AND RELY ON APPROPRIATE COMPARABILITY DATA GATHERED BY AN INDEPENDENT COMPENSATION CONSULTANT FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS, AND THEY PREPARE A CONTEMPORANEOUS AND THOROUGH WRITTEN RECORD OF THEIR DELIBERATIONS AND DECISIONS. THIS REBUTTABLE PRESUMPTION PROCESS IS CONDUCTED ANNUALLY WITH RESPECT TO ALL ELEMENTS OF EACH OFFICER'S COMPENSATION AND BENEFITS. THE LAST TIME THIS WAS DONE WAS IN 2017. THE COMMITTEE REVIEWS AND APPROVES IN ADVANCE THE INCENTIVE COMPENSATION GOALS FOR THE PRESIDENT AND CEO AND ANY OTHER OFFICER, AND ASSURES THAT TOTAL CASH COMPENSATION, INCLUDING THE INCENTIVE COMPENSATION, IS REASONABLE. THE COMMITTEE HAS EXPRESSLY DETERMINED THAT THE TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH OFFICER ARE REASONABLE, BASED ON THE REVIEW OF THE MARKET DATA PRESENTED BY THE INDEPENDENT COMPENSATION CONSULTANT AND ON THE REVIEW OF ALL OTHER RELEVANT FACTS AND CIRCUMSTANCES. FORM 990, PART VI, SECTION C, LINE 19 ONLY FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THAT OF THE PRIOR YEAR. BRONXCARE HEALTH SYSTEM 1276 FULTON AVENUE BRONX NY 10456 131974191 HOSPITAL NY 501 (C) (3) 3 N/A 0 BRONX LEBANON SPECIAL CARE CENTER 1265 FULTON AVENUE BRONX NY 10456 133479996 SKILLED NURSING HOME NY 501 (C) (3) 10 BRONXCARE HEALTH SYSTEM 0 BRONXCARE HEALTH SYSTEM NEW DIRECTIONS FUND 1276 FULTON AVENUE BRONX NY 10456 133183084 FUNDRAISING NY 501 (C) (3) 7 BRONXCARE HEALTH SYSTEM 0 1650 BLHC SERVICES CORP 1276 FULTON AVENUE BRONX NY 10456 201841933 RENTAL APARTMENT BUILDING NY 501 (C) (3) 12 A BRONXCARE HEALTH SYSTEM 0 1770 BLHC SERVICES CORP 1276 FULTON AVENUE BRONX NY 10456 202031443 RENTAL APARTMENT BUILDING NY 501 (C) (3) 12 A BRONXCARE HEALTH SYSTEM 0 HIGHBRIDGE WOODYCREST CENTER 936 WOODYCREST AVENUE BRONX NY 10452 133519617 SKILLED NURSING HOME NY 501 (C) (3) 12 A BRONXCARE HEALTH SYSTEM 0 BRONXCARE DEVELOPMENT CORPORATION 3743 WHITE PLAINS ROAD BRONX NY 10467 201556279 REAL ESTATE DEVELOPMENT NY BRONXCARE HEALTH SYSTEM C 1.00000 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 1