2018-11-13T13:30:57-06:00 2017-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL ROCHESTER NY 14534 990 2017-01-01 462602391 ICIRCLE SERVICES OF THE FINGER LAKES INC ICIR 8444247253 860 HARD RD WEBSTER NY 14580 ADAM SOUTHCOTT CFO 5853471209 2018-11-09 1 RICHARD LEICHT P01378913 5853811000 151.181.74.70 2018-11-09 12:47:11 ES P 23025919B01E351967CFBA1C5A22CB7E3130E6CC 7C54B526804E4E2E5F6203C68DA45B52FD5F8660 2017 2019-02-21 02:37:17Z SANKAR SEWNAUTH 860 HARD RD WEBSTER NY 14580 90360788 0 X WWW.ICIRCLECNY.ORG X 2013 NY TO PROVIDE MEMBERS WITH HIGH-QUALITY HEALTH AND SOCIAL SERVICES THAT ARE CULTURALLY-APPROPRIATE, COMMUNITY-INTEGRATED, AND TAILORED TO THEIR INDIVIDUAL NEEDS, ENSURING A POSITIVE IMPACT ON THEIR PERSONAL HEALTH, LIFESTYLE, AND INDEPENDENCE. 18 18 85 18 0 0 1753740 948331 44321122 89412457 0 0 28493 0 46103355 90360788 0 0 0 0 2455870 7177933 0 0 0 44746186 80212281 47202056 87390214 -1098701 2970574 13620074 15806502 18621583 16460770 -5001509 -654268 TO PROVIDE MEMBERS WITH HIGH-QUALITY HEALTH AND SOCIAL SERVICES THAT ARE CULTURALLY-APPROPRIATE, COMMUNITY-INTEGRATED, AND TAILORED TO THEIR INDIVIDUAL NEEDS, ENSURING A POSITIVE IMPACT ON THEIR PERSONAL HEALTH, LIFESTYLE, AND INDEPENDENCE. 0 0 86051183 89412457 APPROXIMATELY MANAGED LONG TERM CARE INSURANCE2300 INDIVIDUALS SERVED 785280 0 DEVELOPMENTAL DISABILITIES INDIVIDUAL SUPPORT AND CARE COORDINATION ORGANIZATION 86836463 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 20 0 85 0 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 0 1 0 NY X ADAM SOUTHCOTT 5853471054 860 HARD RD WEBSTER NY 14580 JOSEPH GABRIEL BOARD VICE CHAIR 1.00 X X 0 0 0 WILLIAM WOODARD TREASURER 1.00 X X 0 0 0 GREG GRIBBEN INTERIM VICE CHAIRPERSON 1.00 X X 0 0 0 MARY WALSH-BOATFIELD BOARD MEMBER 1.00 X 0 0 0 HILDA ROSARIO-ESCHER BOARD MEMBER 1.00 X 0 0 0 EDWARD HAYES BOARD MEMBER 1.00 X 0 0 0 ROBERT RELPH BOARD MEMBER 1.00 X 0 0 0 RENE' SNYDER BOARD MEMBER 1.00 X 0 0 0 PATRICIA FRATANGELO BOARD MEMBER 1.00 X 0 0 0 ERIC GILBERT BOARD MEMBER 1.00 X 0 0 0 RICH YARMEL BOARD MEMBER 1.00 X 0 0 0 JEFF SINSEBOX BOARD MEMBER 1.00 X 0 0 0 SY ZIELINSKI BOARD MEMBER 1.00 X 0 0 0 LORI VANAUKEN BOARD MEMBER 1.00 X 0 0 0 JENNIFER CARLSON INTERIM SECRETARY 1.00 X X 0 0 0 RICH FERRARI INTERIM BOARD CHAIR 1.00 X X 0 0 0 DENNIS BUCHAN BOARD MEMBER 1.00 X 0 0 0 MARIA DIBBLE BOARD MEMBER 1.00 X 0 0 0 HENRY PASZKO CMO 24.00 X 231049 0 7716 SANKAR SEWNAUTH PRESIDENT 1.00 39.00 X 0 610392 13428 ADAM SOUTHCOTT CFO 40.00 X 71642 0 900 SHARON MARBLE COO 40.00 0.00 X 197509 0 10484 DEBRA LITZENBERGER VP OF CLINICAL OPERATIONS 40.00 X 118266 0 6305 KIMBERLEY FONTAINE ASSESSMENT NURSE SUPERVISOR 40.00 X 102255 0 9810 KAREN FUSILLI ASSESSMENT RN 40.00 X 101505 0 10006 822226 610392 58649 5 0 1 0 ER SELECT LLC 7 LINDEN PARK ROCHESTER NY 14625 RECRUITING 120000 1 848331 100000 948331 MEDICAID PREMIUM REVENUE 524126 80710010 80710010 SPENDDOWN AND NAMI 524126 8702447 8702447 89412457 90360788 89412457 0 0 311307 311307 5465367 5465367 61796 61796 861280 861280 478183 478183 1247322 693626 553696 167273 167273 36050 36050 779855 779855 144957 144957 76242 76242 129240 129240 89796 89796 55 55 159602 159602 150013 150013 16524 16524 MEDICAL EXPENSES 75781659 75781659 BAD DEBT EXPENSE 1294201 1294201 EQUIPMENT RENTAL AND MA 55023 55023 PARTICIPANT TRANSPORTAT 50800 50800 33669 33669 87390214 86836463 553751 0 8422295 5906557 3545020 6525988 105859 603564 178322 419366 425242 1233393 2842856 13620074 15806502 13016641 12470730 5604942 3990040 18621583 16460770 X -5001509 -654268 -5001509 -654268 13620074 15806502 X 2970574 1376667 X X 0 1 X 1 1 1 X 217578 1753740 948331 2919649 9033794 44321122 89412457 142767373 9251372 46074862 90360788 145687022 0 0 0 145687022 31850 28493 60343 9283222 46103355 90360788 145747365 X 154852 44596 110256 168042 45714 122328 280670 88012 192658 425242 RESTRICTED DEPOSITS 2727700 CURRENT PORTION OF DUE FROM RELATED PARTIES 115156 2842856 UNSECURED NOTE PAYABLE TO RELATED PARTY 3990040 3990040 90360788 0 90360788 0 90360788 87390214 0 87390214 0 87390214 0 0 0 0 0 0 0 0 0 HENRY PASZKO CMO 195745 0 34478 0 826 0 517 0 7199 0 238765 0 0 0 SANKAR SEWNAUTH PRESIDENT 0 335519 0 129351 0 145522 0 978 0 12450 0 623820 0 0 SHARON MARBLE COO 156811 0 28144 0 12554 0 978 0 9506 0 207993 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S MEMBERS INCLUDE INDIVIDUALS ENROLLED IN MEDICAID IN 22 COUNTIES THROUGHOUT THE WESTERN, CENTRAL, AND SOUTHERN TIER REGIONS OF NEW YORK. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE ORGANIZATION'S FINAL FORM 990 WAS PROVIDED IN ELECTRONIC FORM TO EACH VOTING MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING THE FORM. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS WRITTEN CONFLICT OF INTEREST POLICY BY REQUIRING ALL EMPLOYEES, VOLUNTEERS, CONSULTANTS, AND BOARD MEMBERS UPON JOINING THE ORGANIZATION AND ANNUALLY THEREAFTER TO REVIEW, COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT TO REPORT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. REPORTS OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST ARE REPORTED TO THE DIRECTOR OF QA, THE EXECUTIVE TEAM, OR TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FOR RESOLUTION, AS NEEDED. FORM 990, PART VI, SECTION B, LINE 15B THE ORGANIZATION USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSUTANT, COMPENSATION SURVEYS, WRITTEN EMPLOYMENT CONTRACTS, AND APPROVAL BY THE BOARD OF DIRECTORS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S KEY EMPLOYEES. 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. FORM 990, PART XI, LINE 9: PRIOR YEAR REVENUE (EXPENSE) ADJUSTMENTS, NET 1,376,667. 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