2013-10-28T17:04:19-05:00 2012-12-31 420714325 MCGLADREY LLP 1185 AVENUE OF THE AMERICAS NEW YORK NY 100362602 990 2012-01-01 132739694 CHARLES B WANG COMMUNITY HEALTH CENTER INC CHAR 2123796988 268 CANAL STREET NEW YORK NY 10013 JANE T ENG 2123796988 2013-10-28 1 MARTIN GREIF P00029738 2123721000 2012 2016-03-07 17:11:31Z JANE T ENG 268 CANAL STREET NEW YORK NY 10013 41735499 0 X WWW.CBWCHC.ORG X 1972 NY TO BE A LEADER IN PROVIDING QUALITY, CULTURALLY RELEVANT, AND AFFORDABLE HEALTH CARE AND EDUCATION, AND TO ADVOCATE ON BEHALF OF THE HEALTH AND SOCIAL NEEDS OF UNDERSERVED ASIAN AMERICANS 16 15 583 27 0 0 8241051 7778579 29869824 33320653 33262 40334 305808 595933 38449945 41735499 0 0 0 0 29640433 29473534 0 0 11417 9051937 9945110 38692370 39418644 -242425 2316855 31194628 34721969 6662429 7867125 24532199 26854844 OUR MISSION IS TO BE A LEADER IN PROVIDING QUALITY, CULTURALLY RELEVANT, AND AFFORDABLE HEALTH CARE AND EDUCATION, AND TO ADVOCATE ON BEHALF OF THE HEALTH AND SOCIAL NEEDS OF UNDERSERVED ASIAN AMERICANS. 0 0 33528162 33326098 THE ORGANIZATION OPERATED A FEDERALLY QUALIFIED HEALTH CENTER, WHICH HAD 214,518 VISITS IN 2012. 33528162 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 0 0 0 0 0 0 0 0 0 1 24 0 1 583 1 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X LYNN D SHERMAN 2123796988 268 CANAL STREET NEW YORK NY 10013 X KENNY CHIN 4.00 X X 0 0 0 CHUN K YIP MD 3.00 X X 0 0 0 MARY AGNES PAN 3.00 X X 0 0 0 JAMES WONG 3.00 X X 0 0 0 ROBERT BELL 2.00 X 0 0 0 ROBERT CHANG 2.00 X 0 0 0 IRENE CHU 2.00 X 0 0 0 PYSER EDELSACK 2.00 X 0 0 0 TIMOTHY HSU 2.00 X 0 0 0 DOUGLAS JUNG 2.00 X 0 0 0 MARIE LAM 2.00 X 0 0 0 VICTOR LEE 2.00 X 0 0 0 JOHN LI MD 2.00 X 0 0 0 YVONNE LIU 2.00 X 0 0 0 KENNETH SHIEH 2.00 X 0 0 0 PAULINE TSE 2.00 X 0 0 0 JEANNE LEE JACKSON 2.00 X 0 0 0 EMILY WOO 3.00 X 0 0 0 LILY TANG 2.00 X 0 0 0 YVONNE GHAW 3.00 X 0 0 0 HELEN CHONG 2.00 X 0 0 0 JANE ENG ESQ 35.00 X 289257 0 35582 LYNN SHERMAN 35.00 X 200319 0 33613 BETTY K CHENG 35.00 X 184234 0 12693 REGINA F LEE ESQ 35.00 X 181837 0 20684 PERRY PONG MD 35.00 X 237610 0 34382 SHAO-CHEE SIM 35.00 X 171315 0 31147 KIN CHING KONG MD 35.00 X 408533 0 32099 JIEYING SHEN MD 35.00 X 357399 0 27812 JIAN-PING CHEN MD 35.00 X 281939 0 31665 CHRISTINE J SHEN MD 35.00 X 243090 0 25302 LORETTA AU MD 35.00 X 217151 0 13621 2772684 0 298600 54 0 1 0 GANNON CONTRACTING LLC 49 WEST 38TH STREET NEW YORK NY 10018 CONSTRUCTION 1074245 DONG & TANG INC 728 MEEKER AVENUE BROOKLYN NY 11222 CONSTRUCTION 228317 MCGLADREY LLP 1185 AVENUE OF THE AMERICAS NEW YORK NY 10036 ACCOUNTING & TAX SERVICES 113540 GE HEALTHCARE PO BOX 640944 PITTSBURGH PA 15264 ELECTRONIC MEDICAL RECORDS 100656 4 4341527 3437052 7778579 MEDICAID 900099 21838559 21838559 OTHER THIRD PARTY 900099 5871380 5871380 MEDICAL HOME 900099 1656379 1656379 NYS UNCOMPENSATED CARE 900099 1438335 1438335 SELF-PAY 900099 1157593 1157593 1358407 1358407 33320653 40334 40334 INSURANCE CLAIM PROCEEDS 900099 308031 308031 EXP REIMB-501(C)(3)ORG 900099 217662 217662 MISCELLANEOUS INCOME 900099 64795 64795 5445 5445 595933 41735499 33326098 0 630822 1403480 1212071 191409 22074617 19064042 3010575 852344 736100 116244 3600588 3109533 491055 1542505 1332135 210370 42016 42016 125310 125310 415419 247930 167489 1236488 1015689 220799 3360315 2839466 520849 38974 33659 5315 183792 158726 25066 1128917 953935 174982 130865 78656 52209 LABORATORY & RADIOLOGY 962393 962393 PHARMACEUTICALS 935615 935615 REPAIRS & MAINTENANCE 751166 369839 381327 DUES AND SUBSCRIPTIONS 238592 129982 108610 395248 348391 35440 11417 39418644 33528162 5879065 11417 2000 2000 11123273 14039333 2183685 1057321 2662046 3610587 572529 288723 23615175 10724666 12355994 12890509 11101 16891 2284000 2816605 31194628 34721969 4766568 5005895 19123 18602 1876738 2842628 6662429 7867125 X 23703341 26654511 828858 200333 24532199 26854844 31194628 34721969 2316855 5790 0 X 0 1 X 1 1 1 X 8795837 9743897 11319078 8241051 7778579 45878442 26193965 27544356 27743629 29869824 33320653 144672427 34989802 37288253 39062707 38110875 41099232 190550869 0 0 0 190550869 326879 175287 63685 33246 40334 639431 326879 175287 63685 33246 40334 639431 234662 278060 308837 305808 595933 1723300 35551343 37741600 39435229 38449929 41735499 192913600 0.98780 0.98810 0.00330 0.00470 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MEDICAL RECORDS MISCELLANEOUS CHC FDTN REVENUE INSURANCE CLAIM PROCEEDS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 16597236 4966117 11631119 4409097 3546120 862977 2608842 2212429 396413 12890509 SECURITY DEPOSITS 416657 DEFERRED COMPENSATION ACCOUNT 2399948 2816605 DEFERRED COMPENSATION PAYABLE 2399948 DEFERRED RENT 442680 2842628 X 41749089 5790 7800 13590 41735499 0 41735499 39426444 7800 7800 39418644 0 39418644 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: AT DECEMBER 31, 2012, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES. THE HEALTH CENTER FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAXES). WHEN THE RETURN IS FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH CENTERS INCLUDE SUCH MATTERS AS THE FOLLOWING: TAX-EXEMPT STATUS OF THE ENTITY, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME TAX (UBIT). UBIT IS REPORTED ON INTERNAL REVENUE SERVICE FORM 990-T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH THE TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. FORM 990, FILED BY THE HEALTH CENTER, IS SUBJECT TO EXAMINATION UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. X X X 0 0 0 0 0 0 0 0 0 JANE ENG ESQ 287673 0 0 0 1584 0 15000 0 20582 0 324839 0 0 0 LYNN SHERMAN 199767 0 0 0 552 0 12221 0 21392 0 233932 0 0 0 BETTY K CHENG 182650 0 0 0 1584 0 10959 0 1734 0 196927 0 0 0 REGINA F LEE ESQ 180253 0 0 0 1584 0 10959 0 9725 0 202521 0 0 0 PERRY PONG MD 237058 0 0 0 552 0 13017 0 21365 0 271992 0 0 0 SHAO-CHEE SIM 171075 0 0 0 240 0 10500 0 20647 0 202462 0 0 0 KIN CHING KONG MD 408293 0 0 0 240 0 7847 0 24252 0 440632 0 0 0 JIEYING SHEN MD 356952 0 0 0 447 0 6420 0 21392 0 385211 0 0 0 JIAN-PING CHEN MD 281387 0 0 0 552 0 9098 0 22567 0 313604 0 0 0 CHRISTINE J SHEN MD 242858 0 0 0 232 0 5410 0 19892 0 268392 0 0 0 LORETTA AU MD 216599 0 0 0 552 0 10864 0 2757 0 230772 0 0 0 CENTRE COURT HOLDINGS LLC IRENE CHU, BOARD MEMBER, HAS A FINANCIAL INTEREST IN THE INTERESTED PERSON 345636 RENT - IRENE CHU, BOARD MEMBER, HAS A FINANCIAL INTEREST IN CENTRE COURT HOLDINGS, LLC, WHICH RENTS SPACE TO THE HEALTH CENTER. 0 FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY SENIOR MANAGEMENT, INCLUDING THE CEO & CFO. COPIES ARE DISTRIBUTED TO THE BOARD OF DIRECTORS 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, AND PERIODIC REVIEWS ARE CONDUCTED BY THE CEO. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, THE EXECUTIVE 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 ARE AVAILABLE UPON REQUEST. FORM 990, PART VII THE ORGANIZATION, IN A FULL TRANSPARENCY POSTURE TO REPORTING, IS REPORTING ALL BENEFITS IN FULL IN PART VII, COLUMN F AND NOT APPLYING THE $10,000 PER ITEM EXCEPTION FOR CERTAIN BENEFITS.