2014-11-15T21:38:23-06:00 2013-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2013-01-01 132707945 DR MARTIN LUTHER KING JR HEALTH CENTER INC DRMA 7186813400 1265 FRANKLIN AVENUE BRONX NY 10456 VICTOR DEMARCO CFO 7186813400 2014-11-14 1 BERNARD GROTELL P01317742 2128674000 2013 2015-11-30 17:44:51Z VICTOR DEMARCO 1265 FRANKLIN AVENUE BRONX NY 10456 42787991 0 X N/A X 1968 NY TO PROVIDE A BROAD RANGE OF HEALTH SERVICES TO A LARGELY ECONOMICALLY DEPRIVED POPULATION. 11 10 413 10 0 0 2027952 2414004 39854334 40271085 0 0 100119 102902 41982405 42787991 0 0 0 0 27268552 28753472 0 0 0 13808272 13705388 41076824 42458860 905581 329131 16365382 14848644 44481030 42635161 -28115648 -27786517 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; 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 34727065 40271085 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. 34727065 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 0 1 0 0 0 0 1 0 0 0 1 0 0 413 1 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 0 0 0 NY X VICTOR DEMARCO 7189018600 1265 FRANKLIN AVENUE BRONX NY 10456 MR MIGUEL A FUENTES JR CEO 1.00 45.00 X X 0 1004968 48436 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 STEVEN ANDERMAN SENIOR VICE PRESIDENT & CH 1.00 42.00 X 0 549949 45836 MR VICTOR G DEMARCO SENIOR VICE PRESIDENT & CH 1.00 45.00 X 0 551020 41670 MR LIONEL STEWART EXECUTIVE DIRECTOR 40.00 X 158051 0 13415 JOSE TIBURCIO MD PHYSICIAN- FAMILY PRACTICE 40.00 X 271027 0 21858 AMPARO RAMIREZ MD PHYSICIAN- MEDICINE 40.00 X 258749 0 41312 VICTOR PAZ MD PHYSICIAN- PSYCHIATRY 40.00 X 274146 0 30301 SAI LAKSHMI AKELLA MD PHYSICIAN- MEDICINE 40.00 X 271081 0 39019 SANDEEP MALIK MD PHYSICIAN- MEDICINE 20.00 X 381434 0 2949 1614488 2105937 284796 7 0 1 0 JZANUS LTD 170 JERICHO TURNPIKE FLORAL PARK NY 11001 OUTSIDE SERVICES 589274 RCM TECHNOLOGIES P O BOX 536342 PITTSBURGH PA 15253 NURSING CONTRACT HELP 439333 TRI-B INDUSTRIES CORP 733 RIDGEDALE AVE SUITE 206 EAST HANOVER NJ 07936 HOUSEKEEPING 363952 APOLLO HEALTH 2 BRIGHTON ROAD SUITE 300 BLOOMFIELD NJ 07003 COLLECTION SERVICE 325668 GOTHAM PER DIEM 75 MAIDEN LANE NEW YORK NY 10038 NURSING CONTRACT HELP 163318 52 1221944 1192060 881944 2414004 PATIENT REVENUE 621400 40271085 40271085 40271085 TOKENS 900099 80303 80303 PARKING LOT 900099 18000 18000 MEDICAL RECORDS FEE 900099 4599 4599 102902 42787991 40271085 0 102902 171466 24005 147461 21473264 17608076 3865188 1736389 1528022 208367 3559138 2918493 640645 1813215 1595629 217586 13904 13904 48931 48931 3928881 3157415 771466 3872968 2982811 890157 706453 621679 84774 3286755 2728007 558748 128816 113358 15458 17972 17972 1043965 866491 177474 199127 175232 23895 DUES AND MEMBERSHIP 68586 60356 8230 RECREATIONAL ACTIVITIES 35999 35999 LICENSES AND PERMITS 7762 7762 BOOKS AND PERIODICALS 1163 1163 344106 302567 41539 42458860 34727065 7731795 0 410463 1232674 152417 148912 3871242 3639826 2677 18959207 13272772 6354969 5686435 5573614 4140797 16365382 14848644 3928180 3552512 40552850 39082649 44481030 42635161 X -28115648 -27786517 -28115648 -27786517 16365382 14848644 329131 0 X X 0 1 X 1 1 1 X 2057171 2188012 2028738 2027952 2414004 10715877 44964779 33697818 33124181 39854334 40271085 191912197 47021950 35885830 35152919 41882286 42685089 202628074 0 0 0 202628074 79854 197110 613854 100119 102902 1093839 47101804 36082940 35766773 41982405 42787991 203721913 0.99460 0.99350 0.00000 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME PARKING LOT TOKENS MEDICAL RECORDS FEE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9795920 5538954 4256966 9122474 7555480 1566994 40813 178338 -137525 5686435 DUE FROM THIRD PARTIES 4140797 4140797 DUE TO THE BRONX-LEBANON HOSPITAL CENTER 38042649 DUE TO THIRD PARTIES 1040000 39082649 X 42787991 0 42787991 0 42787991 42458860 0 42458860 0 42458860 PART X, LINE 2: THE CENTER HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2010 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. 0 1 0 0 0 0 0 1 0 MR MIGUEL A FUENTES JR CEO 0 980826 0 0 0 24142 0 28841 0 19595 0 1053404 0 0 MR STEVEN ANDERMAN SENIOR VICE PRESIDENT & CH 0 528093 0 0 0 21856 0 21834 0 24002 0 595785 0 0 MR VICTOR G DEMARCO SENIOR VICE PRESIDENT & CH 0 529164 0 0 0 21856 0 21834 0 19836 0 592690 0 0 MR LIONEL STEWART EXECUTIVE DIRECTOR 156329 0 0 0 1722 0 12081 0 1334 0 171466 0 0 0 JOSE TIBURCIO MD PHYSICIAN- FAMILY PRACTICE 172685 0 93022 0 5320 0 21834 0 24 0 292885 0 0 0 AMPARO RAMIREZ MD PHYSICIAN- MEDICINE 155241 0 103240 0 268 0 21834 0 19478 0 300061 0 0 0 VICTOR PAZ MD PHYSICIAN- PSYCHIATRY 183284 0 90130 0 732 0 21834 0 8467 0 304447 0 0 0 SAI LAKSHMI AKELLA MD PHYSICIAN- MEDICINE 157495 0 113485 0 101 0 21834 0 17185 0 310100 0 0 0 SANDEEP MALIK MD PHYSICIAN- MEDICINE 76154 0 305280 0 0 0 2949 0 0 0 384383 0 0 0 PART I, LINE 3 THE HOSPITAL, A RELATED ENTITY, USES COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT,WRITTEN EMPLOYMENT CONTRACT AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE THE CEO SALARY. PART I, LINE 4B JOSE TIBURCIO, MD. $5,200 PART I, LINE 7 THE BONUSES FOR DR. SANDEEP MALIK, SAI LAKSHMI AKELLA, VICTORIA PAZ, AMPARO RAMIREZ AND JOSE TIBURCIO ARE BASED UPON ACHIEVEMENT OF GOALS SET AT THE BEGINNING OF THE YEAR WITH MR. FUENTES. X 1 881944 COST 0 0 0 PART I, COLUMN (B): SCHEDULE M, PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBERS OF CONTRIBUTORS. FORM 990, PART VI, SECTION A, LINE 6 THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE BRONX LEBANON HOSPITAL CENTER ARE THE SOLE MEMBERS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE CHIEF EXECUTIVE OFFICER APPOINTS ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 WILL BE DISTRIBUTED TO THE BOARD OF DIRECTORS AT THE NEXT BOARD MEETING AFTER THE SUBMISSION OF THE 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 ALL ELEMENTS OF COMPENSATION AND BENEFITS PROVIDED TO THE CHIEF EXECUTIVE OFFICER ARE REVIEWED AND APPROVED IN ADVANCE BY THE COMPENSATION 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 THE CEO'S COMPENSATION AND BENEFITS. THE LAST TIME THIS WAS DONE WAS IN 2013. THE COMMITTEE REVIEWS AND APPROVES IN ADVANCE THE INCENTIVE COMPENSATION GOALS FOR THE CEO, AND ASSURES THAT TOTAL CASH COMPENSATION, INCLUDING THE INCENTIVE COMPENSATION OPPORTUNITY, IS REASONABLE. THE COMMITTEE HAS EXPRESSLY DETERMINED THAT THE TOTAL COMPENSATION AND BENEFITS PROVIDED TO THE CEO 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. PART VI LINE 15 THE HOSPITAL, A RELATED ENTITY, USES THIS PROCESS TO DETERMINE THE CEOS SALARY 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 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 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0