2017-10-31T10:35:35-05:00 2016-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2016-01-01 132739694 CHARLES B WANG COMMUNITY HEALTH CENTER INC CHAR 2123796988 268 CANAL STREET NEW YORK NY 10013 jane t eng CEO 2123796988 2017-10-30 1 THOMAS LANNING P00851654 2122970400 2017-10-18 209.3.217.20 2017-10-30 12:57:06 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 90CC17281F34CD083B051E620E31C1B2A26173FC 2016 2021-01-29 14:40:06Z jane t eng 268 CANAL STREET NEW YORK NY 10013 56818731 0 X www.cbwchc.org X 1972 NY PROVIDE HIGH QUALITY AND AFFORDABLE HEALTH CARE TO THE UNDERSERVED, WITH A FOCUS ON ASIAN AMERICANS. 19 18 736 21 0 0 11801408 9296250 41240565 44047545 -188675 190132 4018303 3284804 56871601 56818731 0 0 0 0 38190421 41863253 0 0 0 13566197 14766614 51756618 56629867 5114983 188864 59878844 61847590 10887984 12279469 48990860 49568121 PROVIDE HIGH QUALITY AND AFFORDABLE HEALTH CARE TO THE UNDERSERVED, WITH A FOCUS ON ASIAN AMERICANS. 0 0 49205704 47332349 The organization operated a federally qualified health center, which had 244,324 visits in 2016. 49205704 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 33 0 1 736 1 0 0 0 0 0 0 0 0 0 0 X 19 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X LYNN D SHERMAN 2123796988 268 CANAL STREET NEW YORK NY 10013 Emily Woo Board Member 2.00 X 0 0 0 Irene Chu Treasurer 3.00 X X 0 0 0 James Wong Board Member 2.00 X 0 0 0 Jeanne Lee Jackson Board Member 2.00 X 0 0 0 Jiming Liang Vice Chairperson 3.00 X X 0 0 0 Kenny Chin Esq Board Member 2.00 X 0 0 0 Leslie Chuang MD Board Member 2.00 X 0 0 0 Marie Lam Board Member 2.00 X 0 0 0 MARY AGNES PAN Board Member 2.00 X 0 0 0 Owh Kian Ong Board Member 2.00 X 0 0 0 Pauline Tse Board Member 2.00 X 0 0 0 Philip Chong Jr Board Member 2.00 X 0 0 0 ROBERT BELL Board Member 2.00 X 0 0 0 Sophia Tsao Secretary 3.00 X X 0 0 0 Stephanie Cheng Board Member 2.00 X 0 0 0 Timothy Hsu Board Member 2.00 X 0 0 0 Victor Lee Chairperson 4.00 X X 0 0 0 William Tam Board Member 2.00 X 0 0 0 Yvonne Ghaw Board Member 2.00 X 0 0 0 Betty K Cheng Chief Operating Officer 35.00 X 228322 0 21041 JANE T ENG ESQ Chief Executive Officer 35.00 X 342074 0 41823 Lynn D Sherman Chief Financial Officer 35.00 X 248491 0 42616 Kenneth Shieh Chief Strategy Officer 35.00 X 190140 0 14886 PERRY PONG MD Chief Medical Officer 35.00 X 295996 0 42667 REGINA F LEE ESQ Chief Development Officer 35.00 X 228436 0 32328 ALLAN HO MD Chief of OBGYN 35.00 X 418427 0 26824 CHRISTINE J SHEN MD Senior Pediatrician II 35.00 X 342155 0 32935 Du Chu Wu MD Senior Internist Level I 35.00 X 302783 0 37171 JIAN-PING CHEN MD MD of Mental Health 35.00 X 309211 0 41220 JIE YING SHEN MD Senior Pediatrician II 35.00 X 434847 0 34178 3340882 0 367689 64 0 1 0 Proskauer Rose LLP Eleven Times Square New York NY 10036 Legal Services 199921 Paladin Consulting 755 West End Avenue Suite 14B new York NY 10025 Computer Consulting 141958 COhnReznick LLP 1301 Avenue of the Americas New York NY 10019 Accounting and Tax Services 123750 3 7065706 2230544 2054925 9296250 NEW YORK STATE MEDICAID MANAGED C 621400 18846000 18846000 Medicaid managed care 621400 8671477 8671477 private insurance 621400 8415562 8415562 Medicaid 621400 3144649 3144649 new york state uncompensated care 621400 2311009 2311009 2658848 2658848 44047545 190132 190132 HEALTH PLAN QUALITY DISTRIBUTION 900099 2728821 2728821 management services fees 900099 250573 250573 meaningful use incentive 900099 242250 242250 63160 63160 3284804 56818731 47332349 0 190132 1728821 1503136 225685 32054529 27869970 4184559 1272603 1106498 166105 4179012 3633551 545461 2628288 2285233 343055 91677 91677 144550 144550 586234 489966 96268 1001525 861290 140235 3899795 3321845 577950 358138 237187 120951 229508 151998 77510 1296116 1104032 192084 158541 62780 95761 Donated vaccines 2054925 2054925 Pharmaceuticals 1694668 1694668 Equpment rental and mai 873883 719327 154556 Consumable supplies 758361 639772 118589 1618693 1469526 149167 56629867 49205704 7424163 0 1067781 1332421 22686603 10563326 1048641 1980010 5631240 7566476 500652 617373 44558842 15380224 13707756 29178618 10466562 5987156 4769609 4622210 59878844 61847590 6922986 7725697 3964998 4553772 10887984 12279469 X 48553485 49439980 437375 128141 48990860 49568121 59878844 61847590 188864 388397 0 X X 0 1 X 1 1 1 X 7778579 7891204 7989685 11801408 9296250 44757126 33320653 45662634 41220402 41847842 44047545 206099076 41099232 53553838 49210087 53649250 53343795 250856202 0 0 0 250856202 40334 35213 154698 322058 190132 742435 40334 35213 154698 322058 190132 742435 595933 519145 3134268 3411026 3284804 10945176 41735499 54108196 52499053 57382334 56818731 262543813 0.95550 0.96050 0.00280 0.00240 X Schedule A, Part III, Line 12, Explanation of Other Income: Health plan quality distribution - 2014 Amount: $ 1,957,315. 2015 Amount: $ 2,337,220. 2016 Amount: $ 2,728,821. Meaningful use incentive - 2014 Amount: $ 463,250. 2015 Amount: $ 416,500. 2016 Amount: $ 242,250. Management services fees - 2012 Amount: $ 217,662. 2013 Amount: $ 230,562. 2014 Amount: $ 238,555. 2015 Amount: $ 243,654. 2016 Amount: $ 250,573. Metrocard reimbursement - 2014 Amount: $ 239,803. 2015 Amount: $ 364,095. Medical records charges - 2013 Amount: $ 22,731. 2014 Amount: $ 27,520. 2015 Amount: $ 37,457. 2016 Amount: $ 42,103. Other - 2012 Amount: $ 5,445. 2013 Amount: $ 265,852. 2014 Amount: $ 207,825. 2015 Amount: $ 12,100. 2016 Amount: $ 21,057. insurance plan proceeds - 2012 Amount: $ 308,031. miscellaneous income - 2012 Amount: $ 64,795. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14958494 14958494 19396199 7701299 11694900 5544213 4772794 771419 4659936 2906131 1753805 29178618 SECURITY DEPOSITS 621293 DEFERRED COMPENSATION ACCOUNT 4000917 4622210 DEFERRED COMPENSATION PAYABLE 4000917 DEFERRED RENT 552855 4553772 X 57526441 388397 2640 316673 707710 56818731 0 56818731 56949180 2640 2640 56946540 -316673 -316673 56629867 Part X, Line 2: The Center has no unrecognized tax benefits at December 31, 2016. The Center's Federal and state income tax returns prior to fiscal year 2013 are closed and management continually evaluates expiring statutes of limitations, audits, proposed settlements, changes in tax law and new authoritative rulings. The Center 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: employee benefit reimbursements 316,673. Part XII, Line 4b - Other Adjustments: employee benefit reimbursements -316,673. X X X X 0 0 0 0 0 0 0 0 0 Betty K Cheng Chief Operating Officer 207496 0 0 0 20826 0 13564 0 7477 0 249363 0 0 0 JANE T ENG ESQ Chief Executive Officer 322359 0 0 0 19715 0 15900 0 25923 0 383897 0 0 0 Lynn D Sherman Chief Financial Officer 229459 0 0 0 19032 0 15126 0 27490 0 291107 0 0 0 Kenneth Shieh Chief Strategy Officer 171940 0 0 0 18200 0 11565 0 3322 0 205027 0 0 0 PERRY PONG MD Chief Medical Officer 294964 0 0 0 1032 0 15788 0 26880 0 338664 0 0 0 REGINA F LEE ESQ Chief Development Officer 208721 0 0 0 19715 0 13564 0 18764 0 260764 0 0 0 ALLAN HO MD Chief of OBGYN 399395 0 0 0 19032 0 15900 0 10924 0 445251 0 0 0 CHRISTINE J SHEN MD Senior Pediatrician II 323825 0 0 0 18330 0 7615 0 25320 0 375090 0 0 0 Du Chu Wu MD Senior Internist Level I 284327 0 0 0 18456 0 8917 0 28255 0 339955 0 0 0 JIAN-PING CHEN MD MD of Mental Health 290659 0 0 0 18552 0 15900 0 25320 0 350431 0 0 0 JIE YING SHEN MD Senior Pediatrician II 416305 0 0 0 18542 0 8078 0 26100 0 469025 0 0 0 SCHEDULE J, PART II: A PORTION OF THE AMOUNT PRESENTED IN COLUMN B(III) FOR Allan Ho, Christine J. Shen, Jian-Ping Chen, Jie Ying Shen, Kenneth Shieh, Regina F. Lee, Betty K. Cheng, Jane T. Eng, Du Chu Wu, and Lynn D. Sherman REPRESENT AMOUNTS DEFERRED INTO A QUALIFIED RETIREMENT PLAN. CENTRE COURT HOLDINGS LLC Irene Chu, Board member, has financial interest in Centre Court Hldngs LLC 396624 RENT 0 X 1 2054925 fmv 0 0 0 Part I, Column (b): COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS. Form 990, Part VI, Section B, line 11b COPIES OF THE FORM 990 ARE DISTRIBUTED THE BOARD OF DIRECTORS. IT IS REVIEWED BY SENIOR MANAGEMENT, INCLUDING THE CEO AND CFO, AND THE BOARD AUDIT COMMITTEE, WHO PRESENT IT TO THE BOARD OF DIRECTORS FOR A VOTE BEFORE IT IS FILED WITH THE IRS. Form 990, Part VI, Section B, line 12c THE ORGANIZATION'S DIRECTORS, OFFICERS AND KEY EMPLOYEES SIGN DISCLOSURE STATEMENTS ANNUALLY. THE BOARD DEVELOPMENT COMMITTEE AND AUDIT COMMITTEE ARE RESPONSIBLE FOR MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IN THE EVENT A CONFLICT EXISTS, THE INDIVIDUAL WITH THE CONFLICT MUST RECUSE HIMSELF/HERSELF FROM ANY DELIBERATION AND VOTING REGARDING THE CONFLICT. Form 990, Part VI, Section B, line 15a ANNUALLY, THE compensation COMMITTEE OF THE BOARD REVIEWS AND EVALUATES THE CEO AND DECIDES ON COMPENSATION. INFORMATION FROM OUTSIDE CONSULTANTS ON COMPARABLE SALARIES OF SIMILAR ORGANIZATIONS MAY BE USED IN THEIR DETERMINATION. SALARIES FOR OTHER OFFICERS & KEY EMPLOYEES ARE DETERMINED BY THE CEO, USING SALARY SURVEYS WITH INFORMATION FROM OTHER HEALTH CENTERS, AS WELL AS EMPLOYEE ANNUAL EVALUATIONS. Form 990, Part VI, Section C, line 19 COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AREAVAILABLE UPON REQUEST. form 990, part XII, line 2c: No change from prior period process.