2016-11-09T17:25:12-06:00 2015-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2015-01-01 132707945 DR MARTIN LUTHER KING JR HEALTH CENTER INC DRMA 7186813400 1265 FRANKLIN AVENUE BRONX NY 10456 VICTOR DEMARCO SENIOR VICE PRESIDENT & CFO 7186813400 2016-11-09 1 AARON SHAPIRO P01333816 2128674000 2015 2017-02-10 21:41:12Z VICTOR DEMARCO 1265 FRANKLIN AVENUE BRONX NY 10456 46578873 0 X N/A X 1968 NY TO PROVIDE A BROAD RANGE OF HEALTH SERVICES TO A POPULATION THAT IS LARGELY ECONOMICALLY DEPRIVED. 11 10 392 10 0 0 1975503 2426749 42330208 44046547 0 0 116025 105577 44421736 46578873 0 0 0 0 27985984 29229697 0 0 0 14227782 14858647 42213766 44088344 2207970 2490529 14099697 14106530 39678244 37194548 -25578547 -23088018 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 36035981 44046547 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. 36035981 1 1 0 0 0 0 0 0 0 0 1 0 0 1 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 0 392 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 0 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 1714333 54293 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 844707 43096 MR LIONEL STEWART EXECUTIVE DIRECTOR 40.00 X 218922 0 17093 SANDEEP MALIK MD PHYSICIAN- MEDICINE 40.00 X 275430 0 6824 AMPARO RAMIREZ MD PHYSICIAN- MEDICINE 40.00 X 298469 0 45238 YASEMIN BALDIK MD PHYSICIAN-PSYCHIATRY 40.00 X 267504 0 3798 PAYAL PATEL MD PHYSICIAN- MEDICINE 40.00 X 406019 0 3675 SHARON KIM MD CHIEF OF SERVICE INTERNAL 40.00 X 324895 0 30163 1791239 2559040 204180 62 0 1 0 DNA HEALTHCARE 15 CORPORATE PLAXE SOUTH SUITE 301 PISCATAWAY NJ 08854 BILLING 482738 SCHUR MANAGEMENT 2432 GRAND CONCOURSE BRONX NY 10458 RENTAL CONTRACT 403476 RCM TECHNOLOGIES P O BOX 536342 PITTSBURGH PA 15253 NURSING CONTRACT 264950 JZANUS LTD 170 JERICHO TURNPIKE FLORAL PARK NY 11001 BILLING 198061 SECURE LOGISTICS 15 STONEWWALL CIRCLE WHITEPLAINS NY 10607 NURSING CONTRACT 155068 5 821489 1605260 744989 2426749 PATIENT REVENUE 621400 44046547 44046547 44046547 TRAVEL REIMBURSEMENT 900099 85414 85414 PARKING LOT 900099 16500 16500 MEDICAL RECORDS FEE 900099 3663 3663 105577 46578873 44046547 0 105577 236015 33042 202973 21156159 17067007 4089152 1524121 1346666 177455 4355236 3623081 732155 1958166 1723186 234980 25241 25241 27375 27375 3985420 3507170 478250 4703114 3606211 1096903 720944 634430 86514 3651114 3030425 620689 146869 129245 17624 24500 24500 1082705 898645 184060 295428 259977 35451 DUES AND MEMBERSHIP 48877 43012 5865 RECREATIONAL ACTIVITIES 37424 37424 LICENSES AND PERMITS 1879 1879 107757 94581 13176 44088344 36035981 8052363 0 1162270 3514561 157887 308586 3844852 3264118 63874 40282 19447593 15448755 4911764 3998838 3959050 2980145 14099697 14106530 4068611 4027133 35609633 33167415 39678244 37194548 X -25578547 -23088018 -25578547 -23088018 14099697 14106530 2490529 0 X X 0 1 X 1 1 1 X 2028738 2027952 2414004 1975503 2426749 10872946 33124181 39854334 40271085 42330208 44046547 199626355 35152919 41882286 42685089 44305711 46473296 210499301 0 0 0 210499301 613854 100119 102902 116025 105577 1038477 35766773 41982405 42787991 44421736 46578873 211537778 0.99510 0.99440 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: TRAVEL REIMBURSEMENT PARKING LOT MEDICAL RECORDS FEE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9699697 6833550 2866147 9747896 8615205 1132691 3998838 DUE FROM THIRD PARTIES 2980145 2980145 DUE TO THE BRONX-LEBANON HOSPITAL CENTER 25734457 DUE TO HIGHBRIDGE WOODYCREST CENTER 4000000 DUE TO THIRD PARTIES 3432958 33167415 X 46578873 0 46578873 0 46578873 44088344 0 44088344 0 44088344 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, 2012 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 1182705 0 509754 0 21874 0 34881 0 19412 0 1768626 0 0 MR VICTOR G DEMARCO SENIOR VICE PRESIDENT & CFO 0 627351 0 195000 0 22356 0 23019 0 20077 0 887803 0 0 MR LIONEL STEWART EXECUTIVE DIRECTOR 157279 0 59500 0 2143 0 14895 0 2198 0 236015 0 0 0 SANDEEP MALIK MD PHYSICIAN- MEDICINE 82500 0 192930 0 0 0 6824 0 0 0 282254 0 0 0 AMPARO RAMIREZ MD PHYSICIAN- MEDICINE 160422 0 137531 0 516 0 23019 0 22219 0 343707 0 0 0 YASEMIN BALDIK MD PHYSICIAN-PSYCHIATRY 163194 0 104130 0 180 0 1462 0 2336 0 271302 0 0 0 PAYAL PATEL MD PHYSICIAN- MEDICINE 405154 0 769 0 96 0 3627 0 48 0 409694 0 0 0 SHARON KIM MD CHIEF OF SERVICE INTERNAL 121259 0 203544 0 92 0 3700 0 26463 0 355058 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. PART I, LINE 7 MR. LIONEL STEWART, JOSE TIBURCIO, MD, AMPARO RAMIREZ, MD, JONATHAN LEVINE, MD, SAI LAKSHMI AKELLA, MD AND SHARON KIM, MD WERE AWARDED A BONUS FOR ACHIEVEMENT OF GOALS SET FORTH IN THE BEGINING OF THE YEAR BY MANAGEMENT. SCHEDULE J, PART II, MR. MIGUEL A. FUENTES, JR. LINE (I) INCLUDED IN COLUMN B (II): $509,754 REPRESENTING AN ANNUAL BONUS IN RECOGNITION OF THE SIGNIFICANT CONTRIBUTIONS MADE BY PRESIDENT & CEO IN 2015. 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. THE BONUS FOR SENIOR VICE PRESDIENT & CFO, IS BASED UPON THE ACHIEVEMENT OF GOALS SET AT THE BEGINNING OF THE YEAR WITH THE PRESIDENT & CEO. X 1 744989 COST 0 0 0 PART I, COLUMN (B): DR. MARTIN LUTHER KING, JR. HEALTH CENTER, INC. IS REPORTING THE NUMBERS OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY MANAGEMENT AND THEN WILL BE DISTRIBUTED TO THE ENTIRE BOARD OF DIRECTORS FOR REVIEW AT THE NEXT BOARD MEETING AFTER 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 15 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 2015. 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. BRONX LEBANON HOSPITAL CENTER 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) 9 BRONX-LEBANON HOSPITAL CENTER 0 BRONX LEBANON HOSPITAL NEW DIRECTIONS FUND 1276 FULTON AVENUE BRONX NY 10456 133183084 FUNDRAISING NY 501 (C) (3) 7 BRONX-LEBANON HOSPITAL CENTER 0 1650 BLHC SERVICES CORP 1276 FULTON AVENUE BRONX NY 10456 201841933 RENTAL APARTMENT BUILDING NY 501 (C) (3) 11 A BRONX-LEBANON HOSPITAL CENTER 0 1770 BLHC SERVICES CORP 1276 FULTON AVENUE BRONX NY 10456 202031443 RENTAL APARTMENT BUILDING NY 501 (C) (3) 11 A BRONX-LEBANON HOSPITAL CENTER 0 HIGHBRIDGE WOODYCREST CENTER 936 WOODYCREST AVENUE BRONX NY 10452 133519617 SKILLED NURSING HOME NY 501 (C) (3) 11 A BRONX-LEBANON HOSPITAL CENTER 0 BRONXCARE DEVELOPMENT CORPORATION 3743 WHITE PLAINS ROAD BRONX NY 10467 201556279 REAL ESTATE DEVELOPMENT NY THE BRONX LEBANON HOSPITAL C 1.00000 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 1