2016-10-26T11:42:45-05:00 2015-12-31 221478099 COHNREZNICK LLP 1212 Avenue of the Americas New York NY 10036 990 2015-01-01 237360305 URBAN HEALTH PLAN INC URBA 7185891687 1065 SOUTHERN BLVD BRONX NY 10459 Paloma Hernandez President and CEO 7185891687 2016-10-18 1 THOMAS LANNING P00851654 2122970400 2015 2017-02-10 21:41:12Z Paloma Hernandez 1065 SOUTHERN BLVD BRONX NY 10459 90510166 0 X www.urbanhealthplan.org X 1974 NY URBAN HEALTH PLAN'S MISSION IS TO CONTINUOUSLY IMPROVE THE HEALTH OF COMMUNITIES AND THE QUALITY OF LIFE OF THE PEOPLE WE SERVE BY PROVIDING AFFORDABLE, COMPREHENSIVE, QUALITY, PRIMARY AND SPECIALTY HEALTH CARE AND BY ASSURING THE PERFORMANCE AND ADVANCEMENT OF INNOVATIVE BEST PRACTICES. 13 13 928 10 0 0 11646938 13881395 70433476 75891045 26919 3482 3356632 611462 85463965 90387384 2135658 3237812 0 0 55046469 58669269 0 0 1092613 26339923 26105950 83522050 88013031 1941915 2374353 88285233 86936173 58418074 54694661 29867159 32241512 Urban Health Plan is network of federally qualified community health centers in the Bronx and Queens licensed under Article 28 of the New York State law. Its mission is to improve access to primary and specialty services for underserved communities. 0 0 73030809 3237812 74595960 URBAN HEALTH PLAN PRACTICE SITES PROVIDE A BROAD RANGE OF PRIMARY AND SPECIALTY CARE SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION SERVICING UNIQUE PATIENTS AND GENERATING MORE THAN 366,713 VISITS. 1596219 1596219 WIC IS THE SUPPLEMENTAL NUTRITION EDUCATION PROGRAM WHOSE MISSION IS TO PREVENT CHILDHOOD OBESITY. CORE SERVICES PROVIDED INCLUDE HEALTHY LIFESTYE PROGRAMS, BREASTFEEDING SUPPORT, ON-SITE HEMATOLOGY, PARTICIPANT-CENTERED FACILITATED GROUP DISCUSSIONS AND INDIVIDUAL COUNSELING AS AN ADJUNCT TO HEALTH CARE. THE WIC PROGRAM PROVIDE REFERRALS TO OTHER SERVICES FOR ITS CLIENTS. WIC PROVIDES FREE NUTRITIONAL COUNSELING AND VOUCHERS FOR HEALTHY FOOD FOR PREGNANT OR BREASTFEEDING WOMEN AND FOR CHILDREN UNDER AGE 5. 212099 212099 UHP SCHOOL BASED HEALTH PROGRAM INCLUDES 9 CLINICS; 4 ELEMENTARY, 1 MIDDLE SCHOOL, AND 4 HIGH SCHOOLS. THE DENTAL CLINICS ARE STAFFED WITH ONE PROVIDER AND TWO DENTAL ASSISTANTS, WHO ROTATE DAILY TO EACH SCHOOL. DURING THE SCHOOL YEAR JULY 1, 2014 THROUGH JUNE 30, 2015, UHP SERVICED 3,855 STUDENTS TOTALING 12,834 VISITS. 74839127 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 1 1 0 1 0 0 0 1 1 1 0 0 0 1 151 0 1 928 1 0 0 0 0 0 1 1 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X FRANK E LAPORTA VP OF FINANCECFO 7185891687 1231 Lafayette Ave bronx NY 10474 Charles Gonzalez Jr Board Member 1.00 1.00 X 0 0 0 Clifford Charles Treasurer 1.00 1.00 X X 0 0 0 Edward S Butts Board Member 1.00 X 0 0 0 Francia Castro Chairman 1.00 1.00 X X 0 0 0 Frank Estrada MD Board Member 1.00 X 0 0 0 Heroilda Vega Board Member 1.00 X 0 0 0 Joann Rivera Board Member 1.00 X 0 0 0 Joseph Marrero Board Member 1.00 X 0 0 0 Linda Baldwin Board Member 1.00 X 0 0 0 Michelle Carr Secretary 1.00 X X 0 0 0 Nayda Padilla Board Member 1.00 X 0 0 0 Oswaldo Guzman Board Member 1.00 X 0 0 0 Wiener Leblanc MD Vice Chairman 1.00 X X 0 0 0 Frank E LaPorta VP of Finance/CFO 40.00 X 98639 0 1778 Keith Campbell Outgoing Chief Financial Officer 10.00 1.00 X 67944 0 537 Paloma Hernandez President and CEO 35.00 6.00 X 461783 0 118573 Samuel De leon VP and CMO 40.00 X 295106 0 42682 Silva Umukoro Outgoing VP of FIN 10.00 X 86085 0 24540 Berenice Diaz AVP of Finance 35.00 7.00 X 187017 0 14955 Acklema Mohammad Chief of Pediatrics 40.00 X 198596 0 5504 Eileen Leach Chief of Staff 40.00 X 216175 0 16737 Michael Napoli Gynecologist 40.00 X 237568 0 27666 Valeria Loukanova-Ivanov Clinical Director 40.00 X 203322 0 14944 Wilfrido Castillo Associate Medical Director OB/GYN 40.00 X 531205 0 39276 2583440 0 307192 115 0 1 0 E-CLINICAL WORKS LLC POBOX 983122 BOSTON MA 02298 ELECTRONIC HEALTH RECORDS 319860 WILFRIDO CASTILLO 8419 124th Street KEW GARDENS NY 11415 OB/GYN PROVIDER 248107 COHN REZNICK LLP 1212 AVENUE OF THE Americas NEW YORK NY 10036 AUDIT SERVICES 143036 Brightstack Technologies LLC 450 7th Avenue SUITE 802 NEW YORK NY 10123 IT services 129019 THE MIRRAM GROUP LLC 5030 BROADWAY SUITE 807 NEW YORK NY 10034 Strategic Consulting 114166 6 157377 12612414 1111604 2499016 13881395 New York State Medicaid manage ca 621400 34024386 34024386 Managed care plans 621400 23947712 23947712 Medicaid 621400 6231856 6231856 Managed care incentives and share 621400 3780150 3780150 Patient centered medical home pro 621400 2160328 2160328 5746613 5746613 75891045 3482 3482 70300 0 70300 70300 70300 150711 157377 122782 27929 27929 managment fee 541610 240360 240360 investment in CCMP LLC 621110 173419 173419 medical records 900099 38960 38960 60494 60494 513233 90387384 76404278 0 101711 738796 738796 2499016 2499016 1399639 1190184 195305 14150 24235 20466 3531 238 46111240 39356391 6281988 472861 1087477 904491 172919 10067 5949324 4948252 945996 55076 4097354 3407906 651516 37932 117058 117058 130036 130036 32000 32000 4009968 3429381 507636 72951 48991 48991 3310617 2517181 739887 53549 16233 16233 4733228 3668949 1011677 52602 490202 304229 151192 34781 64996 28863 29375 6758 1715168 1689205 25963 4021333 3786736 229881 4716 406565 390097 16468 medical supplies 2563482 2563482 Equipment rental, repai 2425842 1776914 620868 28060 Laboratory fees 703943 703943 Staff training and educ 317582 74428 162564 80590 998706 791226 39198 168282 88013031 74839127 12081291 1092613 5343451 3004784 533380 2798170 1160264 773904 11544426 7899319 200000 200000 106311 152544 735034 643036 87006556 22569558 65495241 64436998 3251223 167042 340461 3000084 3435734 88285233 86936173 9329953 8920498 42295333 40303874 6792788 5470289 58418074 54694661 X 29867159 32241512 29867159 32241512 88285233 86936173 2374353 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 32000 32000 0 Part II-B, Line 1: WORKED WITH NYS ASSEMBLY AND NYC COUNCIL IN EFFORT TO INCREASE FUNDING FOR SERVICES TO THE MEDICALLY UNDERSERVED/UNINSURED INDIVIDUALS/FAMILIES. 1968879 1968879 54579826 2384033 52195793 9899776 8807213 1092563 252766 214113 38653 20305309 11164199 9141110 64436998 capital lease obligations 3607464 DEFERRED COMPENSATION 638172 refundable advances 171602 deferred rent 1053051 5470289 X 90710168 950 199052 200002 90510166 -122782 -122782 90387384 87503290 950 -299766 -298816 87802106 210925 210925 88013031 Part X, Line 2: The Organization has no unrecognized tax benefits at December 31, 2015. The Organization's Federal and state income tax returns prior to fiscal year 2012 are closed and management continually evaluates expiring statutes of limitations, audits, proposed settlements, changes in tax law and new authoritative rulings. The Organization recognizes interest and penalties associated with tax matters as operating expenses and includes accrued interest and penalties with accrued expenses in the consolidated statement of financial position. Part XI, Line 2d - Other Adjustments: Related Organization Revenue 1,360,662. bad debt -210,925. intercompany elimination -950,685. Part XI, Line 4b - Other Adjustments: Fundrasing expenses -122,782. Part XII, Line 2d - Other Adjustments: Related Organization expense 600,070. Fundrasing expenses 122,782. intercompany elimination -1,022,618. Part XII, Line 4b - Other Adjustments: bad debt 210,925. annual GALA 215980 122680 93300 33573 22839 22400 golf outing 92108 34697 57411 11470 26575 5400 525 308088 157377 150711 11470 60148 22839 27800 525 122782 27929 1 Foundation for urban health and well being 1065 southern blvd bronx NY 10459 200565715 501(c)(3) 685256 to support the organization's mission. Bronx Overall Economic Development Corporation 851 grand concourse bronx NY 10451 133079387 501(c)(3) 5500 to support the organizations yearly gala. ECUADORIAN CIVIC COMMITTEE OF NEW YORK INC 41-12 102nd street corona NY 11368 113553172 501(c)(3) 6000 to support the organizations yearly gala. 3 Vaccines 51366 2499016 Fair Market Value Donated Vaccines administered to those in need. Part I, Line 2: contribution to Foundation for urban health and well being was made to a related party, therefore, the board is able to monitor use of funds. The grant to Bronx Overall Economic Development Corporation was given to support the Annual Gala. The Vaccines are administered directly to those in need and require them. X X X 1 1 0 0 0 0 0 1 0 Paloma Hernandez President and CEO 358965 0 83353 0 19465 0 107950 0 10623 0 580356 0 0 0 Samuel De leon VP and CMO 259984 0 15025 0 20097 0 7950 0 34732 0 337788 0 0 0 Berenice Diaz AVP of Finance 155787 0 12000 0 19230 0 4613 0 10342 0 201972 0 0 0 Acklema Mohammad Chief of Pediatrics 188846 0 9750 0 0 0 5504 0 0 0 204100 0 0 0 Eileen Leach Chief of Staff 203583 0 12592 0 0 0 6114 0 10623 0 232912 0 0 0 Michael Napoli Gynecologist 201921 0 35647 0 0 0 5890 0 21776 0 265234 0 0 0 Valeria Loukanova-Ivanov Clinical Director 163002 0 40320 0 0 0 4321 0 10623 0 218266 0 0 0 Wilfrido Castillo Associate Medical Director OB/GYN 482893 0 48312 0 0 0 7061 0 32215 0 570481 0 0 0 Part I, Lines 4a-b Paloma Hernandez PARTICIPATES IN A 457(F) RETIREMENT PLAN. DURING FY 2015 THE organization CONTRIBUTED $100,000 INTO THE PLAN ON HER BEHALF. THIS AMOUNT IS INCLUDED IN THE AMOUNT REPORT ON SCHEDULE J, PART II, COLUMN C. Keith Campbell RECEIVED A SEVERANCE IN 2015 IN THE AMOUNT OF $53,058 and is reported on Part VII, however his total compensation falls below the threshold for schedule J. Part I, Line 7 included on schedule j, part ii, column b(ii) are amounts representing bonuses. these amounts were included in the individuals 2015 w-2s and approved by the board. SCHEDULE J, PART II: A PORTION OF THE AMOUNT PRESENTED IN COLUMN B(III) FOR PALOMA HERNANDEZ AND SAMUEL DE LEON REPRESENT AMOUNTS DEFERRED INTO A QUALIFIED RETIREMENT PLAN. DR RICHARD IZQUIERDO landlord/tenant 915395 THERE IS A LANDLORD AND TENANT RELATIONSHIP BETWEEN URBAN HEALTH PLAN, INC. AND SAN JUAN HEALTH CENTER, INC. IN WHICH URBAN HEALTH PLAN, INC. LEASES COMMERCIAL SPACE FROM SAN JUAN HEALTH CENTER, INC. DR. RICHARD IZQUIERDO IS THE FOUNDER AND MEDICAL DIRECTOR EMERITUS OF URBAN HEALTH PLAN AS WELL AS FATHER OF THE CURRENT CEO OF URBAN HEALTH PLAN, INC. THE LEASED BUILDING IS LOCATED DIRECTLY ACROSS THE STREET FROM URBAN HEALTH PLAN, INC'S MAIN SITE AND IS USED FOR PROGRAMS AND ANCILLIARY SUPPORT SERVICES. IN 2015 URBAN HEALTH PLAN, INC. PAID $915,395 IN RENT, REAL ESTATE TAXES, AND OTHER COMMON AREA CHARGES AS FOLLOWS: RENT $474,615; REAL ESTATE TAXES $136,158; OTHER COMMON AREA CHARGES $304,622. 0 DR RICHARD IZQUIERDO medical director emeritus 41711 DR. IZQUIERDO SERVES AS UHP'S MEDICAL DIRECTOR EMERITUS AND REPRESENTS THE ORGANIZATION IN A PROFESSIONAL AND COMMUNITY RELATIONS CAPACITY. 0 Kristina Hernandez employee 24235 THE Interested PERSON IS AN EMPLOYEE OF THE ORGANIZATION AND IS LISTED ON SCHEDULE L DUE TO A FAMILY RELATIONSHIP WITH THE CEO. The amount listed is the salary of the employee. 0 X 1 2499016 FMV 0 0 0 Part I, Column (b): column b represents the number of contributors. Form 990, Part VI, Section B, line 11 FORM 990 IS prepared by an independent accounting firm and reviewed by UHP's management. The return is then Reviewed BY MEMBERS OF THE FINANCE COMMITTEE OF THE BOARD. once approved by the finance committee, the return is presented to the full board and subsequently filed with the irs. Form 990, Part VI, Section B, line 12c on an annual basis, conflict of interest forms are completed by officers and members of the board. any perceived conflicts are documented and the member is precluded from voting on transations associated with disclosed conflict. Form 990, Part VI, Section B, line 15a THE COMPENSATION COMMITTEE OF THE BOARD REVIEWS AND RECOMMENDS THE SALARY LEVEL OF THE CEO AFTER REVIEWING COMPETITIVE SALARY LEVELS AT SIMILAR ORGANIZATIONS AND COMPENSATION SURVEYS, AS WELL AFTER CONSIDERING THE PERFORMANCE OF THE INDIVIDUAL. Form 990, Part VI, Section C, line 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. Form 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. 1064 SIMPSON STREET LLC 1065 Southern Blvd bronx NY 10459 461761445 rental real estate NY 0 447210 urban health plan 1095 Southern Blvd LLC 1065 Southern Blvd bronx NY 10459 471182724 holding company NY 0 2070565 urban health plan HUNT POINT ECONOMIC DEVELOPMENT CORPORATION 355 Food Center Drive bRONX NY 10474 133475185 economic development NY 501(c)(3) Line 7 uRBAN HEALTH PLAN INC 1 THE FOUNDATION FOR URBAN HEALTH & WELL BEING INC 1065 SOUTHERN BLVD BRONX NY 10459 200565715 PROMOTING THE HEALTHY WELL BEING OF NYC RESIDENTS NY 501(c)(3) Line 7 URBAN HEALTH PLAN INC 1 0 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 1 0 0