2015-02-10T07:57:03-06:00 2014-03-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2013-04-01 200547132 MONMOUTH FAMILY HEALTH CENTER MONM 7329237100 270 BROADWAY LONG BRANCH NJ 07740 ROBERT J AURIEMMA CFO 7329237100 2015-02-06 1 JULIUS GREEN CPA P00350393 2159720701 2013 2016-02-25 16:41:14Z ROBERT J AURIEMMA 270 BROADWAY LONG BRANCH NJ 07740 9766997 0 X N/A X 2005 NJ PROVIDE A BROAD RANGE OF HEALTH SERVICES TO MEDICALLY UNDERSERVED POPULATION IN MONMOUTH COUNTY, NJ. 10 10 94 10 0 0 1940791 3543990 6465446 6194205 23856 8820 6443 19982 8436536 9766997 0 0 0 0 4579895 4575276 0 0 0 3559326 3429511 8139221 8004787 297315 1762210 4409086 6395374 1150508 1374585 3258578 5020789 TO PROVIDE MEDICAL, DENTAL, AND OTHER SOCIAL SERVICES TO THE UNDER SERVED POPULATION OF MONMOUTH COUNTY, NEW JERSEY. 0 0 6309623 6214187 FOR THE FISCAL YEAR ENDED 3/31/2014, THE CENTER PROVIDED OUTPATIENT HEALTHCARE SERVICES TO APPROXIMATELY 18,000 PATIENTS, TOTALING APPROXIMATELY 51,000 VISITS. SERVICES INCLUDED OBSTETRICS / GYNECOLOGY, MEDICINE, PEDIATRICS, DENTAL, PODIATRY AND HIV. THE CENTER CONTINUES TO PROVIDE COMMUNITY IN-REACH, OUTREACH AND ENROLLMENT ASSISTANCE IN ORDER TO MEET ANTICIPATED INCREASES IN PATIENT AND SERVICE AREA NEEDS. 6309623 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 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 0 0 0 0 1 33 0 1 94 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ X ROBERT J AURIEMMA 7329630159 80 PAVILION AVENUE LONG BRANCH NJ 07740 KATHLEEN BILLINGS TRUSTEE 1.00 0.00 X 0 0 0 FATIMA CAMACHO TRUSTEE 1.00 0.00 X 0 0 0 MARGARET FISHER MD TRUSTEE 1.00 0.00 X 0 0 0 ANDRES MEJER TRUSTEE 1.00 0.00 X 0 0 0 RODNEY O'NEAL VICE CHAIRPERSON 1.00 0.00 X X 0 0 0 MICHAEL PERDONI TREASURER 1.00 0.00 X X 0 0 0 DIANA TENNANT TRUSTEE 1.00 0.00 X 0 0 0 WEBSTER TRAMMEL PSY D SECRETARY 1.00 0.00 X X 0 0 0 LAWRENCE KERRIGAN CHAIRPERSON 1.00 0.00 X X 0 0 0 AVIS MCMILLON TRUSTEE 1.00 0.00 X 0 0 0 ROBERT AURIEMMA CFO 40.00 0.00 X 30888 0 6799 MARTA SILVERBERG CEO 40.00 0.00 X 174993 0 18077 RAKSHA JOSHI MD CHIEF MEDICAL OFFICER 40.00 0.00 X 264920 0 27727 AAREFA SHAKIR MD PHYSICIAN 28.00 0.00 X 132475 0 0 MARTIN ARAUJO MD PHYSICIAN 40.00 0.00 X 156565 0 13245 ISABEL BASTOS MD DENTIST 40.00 0.00 X 119414 0 13730 879255 0 79578 5 0 1 0 0 2677516 866474 440319 3543990 MEDICAID 621990 3472764 3472764 NJ UNCOMPENSATED 621990 1510455 1510455 SELF PAY 621990 869401 869401 MEDICARE 621990 224229 224229 OTHER THIRD PARTY 621990 117356 117356 6194205 8820 8820 RECOVERIES/REBATES/ETC 621990 12944 12944 MEDICAL RECORD FEES 621990 7038 7038 19982 9766997 6214187 0 8820 X 547944 418318 129626 3066712 2341227 725485 89682 68467 21215 620580 473771 146809 250358 191131 59227 8771 5220 3551 67083 39927 27156 1334052 1111111 222941 478004 392835 85169 525599 392412 133187 11806 9013 2793 7021 5360 1661 1758 1342 416 240361 179453 60908 59729 44594 15135 DONATED VACCINES 440319 440319 REPAIRS AND MAINTENANCE 184707 137902 46805 DUES & SUBSCRIPTIONS 43794 33434 10360 BAD DEBT EXPENSE 15000 15000 11507 8787 2720 8004787 6309623 1695164 0 693799 800 928731 1791850 2037380 19248 142549 3878688 1196285 1108328 2682403 751761 559411 44100 44100 4409086 6395374 1066102 1214124 77205 160461 7201 0 1150508 1374585 X 3258578 5020789 3258578 5020789 4409086 6395374 1762210 0 X 0 1 X 1 1 1 X 2138095 1963750 1727886 1940791 3543990 11314512 2138095 1963750 1727886 1940791 3543990 11314512 2895312 8419200 10649 19346 29915 23856 8820 92586 26078 10851 15131 6443 19982 78485 11485583 0.73300 0.97920 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2009 AMOUNT: $ 26,078. 2010 AMOUNT: $ 10,851. 2011 AMOUNT: $ 15,131. 2012 AMOUNT: $ 6,443. 2013 AMOUNT: $ 19,982. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 101654 15735 85919 1085000 680165 404835 514799 500385 14414 2177235 2177235 2682403 X 9751997 -15000 -15000 9766997 0 9766997 7989786 0 7989786 15000 15000 8004786 PART X, LINE 2: THE CENTER WAS INCORPORATED AS A NOT-FOR-PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW JERSEY AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"). THEREFORE, THERE IS NO PROVISION FOR INCOME TAXES. THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT MARCH 31, 2014 AND 2013. THE CENTER'S FEDERAL AND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2011 AND 2010, RESPECTIVELY, ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE CENTER HAS FILED ALL REQUIRED PAYROLL TAX RETURNS AND PAYROLL TAXES DUE HAVE BEEN PAID. THE CENTER RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS OPERATING EXPENSES AND INCLUDES ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE BALANCE SHEET. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE -15,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE 15,000. X X 0 0 0 0 0 0 0 0 0 MARTA SILVERBERG CEO 174993 0 0 0 0 0 5302 0 12775 0 193070 0 0 0 RAKSHA JOSHI MD CHIEF MEDICAL OFFICER 264920 0 0 0 0 0 7983 0 19744 0 292647 0 0 0 MARTIN ARAUJO MD PHYSICIAN 156565 0 0 0 0 0 4766 0 8479 0 169810 0 0 0 X 1 440319 CURRENT SALES PRICE 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS IN PART I, COLUMN (B). FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION PROVIDES THE BOARD OF TRUSTEES WITH AN ELECTRONIC COPY OF THE FORM 990 IN ADVANCE OF FILING WITH THE IRS. PRIOR TO FILING, THE TAX PREPARER IS AVAILABLE TO ANSWER ALL QUESTIONS THAT ANY MEMBER OF THE BOARD OF TRUSTEES MAY HAVE. FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, THROUGH BUSINESS, INVESTMENT OR FAMILY IN AN ENTITY OR INDIVIDUAL WITH WHICH THE CORPORATION HAS A TRANSACTION OR ARRANGEMENT MUST COMPLETE A CONFLICT OF INTEREST STATEMENT. IN ADDITION, IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS. DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS MONITOR THE CONFLICT OF INTEREST POLICY ON A REGULAR BASIS. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE INTERESTED PERSON MAY NOT PARTICIPATE IN THE DISCUSSION OF, OR VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTED IN THE CONFLICT OF INTEREST. MANAGEMENT WILL DETERMINE IF THE CONFLICT IS OF A NATURE THAT MUST BE REFERRED TO LEGAL COUNSEL FOR RECOMMENDATION AS TO THE APPROPRIATE ACTION TO BE TAKEN. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO IS DETERMINED VIA INDEPENDENT COMPENSATION SURVEYS, INCLUDING THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE NEW JERSEY PRIMARY CARE ASSOCIATION, TO ENSURE THAT TOTAL ANNUAL COMPENSATION IS COMPARABLE AND DOES NOT EXCEED THE FAIR MARKET VALUE OF CEO POSITIONS IN SIMILAR FEDERALLY QUALIFIED HEALTH CENTERS (FQHC'S) WITHIN THE STATE. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD. THE COMPENSATION OF THE CFO AND CMO IS DETERMINED VIA INDEPENDENT COMPENSATION SURVEYS, INCLUDING THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE NEW JERSEY PRIMARY CARE ASSOCIATION, TO ENSURE THAT TOTAL ANNUAL COMPENSATION IS COMPARABLE AND DOES NOT EXCEED THE FAIR MARKET VALUE OF THESE POSITIONS IN SIMILAR FQHC'S WITHIN THE STATE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE ALL GOVERNING DOCUMENTS TO ANY PERSON OR PERSONS WHO REQUEST THE DOCUMENTS EITHER IN WRITING OR IN PERSON. UPON THE REQUEST, THE ORGANIZATION LOGS WHAT WAS REQUESTED, BY WHOM AND WHERE AND WHEN THE DOCUMENTS WERE SENT. FORM 990, PART IX, LINE 11G DATA PROCESSING FEES: PROGRAM SERVICE EXPENSES 113,839. MANAGEMENT AND GENERAL EXPENSES 77,430. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 191,269. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 997,272. MANAGEMENT AND GENERAL EXPENSES 145,511. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,142,783.