2023-10-18T10:27:06-05:00 2022-12-31 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2022-01-01 510567466 COMMUNITY HEALTH CENTER OF RICHMOND INC COMM 7189242254 439 PORT RICHMOND AVENUE STATEN ISLAND NY 10302 HENRY THOMPSON CEO 7189242254 2023-10-17 1 HENRY THOMPSON 999009999 0 KERRI N BOGDA CPA P00760402 7177404863 2023-10-17 X 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z HENRY THOMPSON 439 PORT RICHMOND AVENUE STATEN ISLAND NY 10302 18210584 0 X WWW.CHCRICHMOND.ORG X 2006 NY TO PROVIDE QUALITY HEALTH CARE AND SPECIALTY SERVICES THAT ARE AFFORDABLE AND ACCESSIBLE. 9 9 102 9 0 0 9893131 8574486 9226878 9134830 647 158 396607 501110 19517263 18210584 0 0 0 0 10884039 11367105 0 0 0 5741134 6068171 16625173 17435276 2892090 775308 22226092 25669194 7591318 10542790 14634774 15126404 X THE MISSION OF THE COMMUNITY HEALTH CENTER OF RICHMOND, INC. (THE CENTER) IS TO PROVIDE AFFORDABLE, QUALITY PRIMARY HEALTH CARE AND COORDINATED ACCESS TO SPECIALTY SERVICES WITH RESPECT AND COMPASSION FOR ALL PEOPLE. 0 0 14418995 9134830 THE CENTER PROVIDES PRIMARY CARE SERVICES TO RESIDENTS OF STATEN ISLAND, NEW YORK WITH PARTICULAR EMPHASIS PLACED ON SERVING THE POOR AND UNDER-INSURED WITHIN THE COMMUNITY. THERE WERE 35,237 VISITS FOR 2022. CHCR HAS PROVIDED SERVICES TO 11,256 PATIENTS OF WHICH 2,166 WERE UNINSURED AND 10,556 WERE AT 200% OR BELOW THE FEDERAL POVERTY GUIDELINE. THERE WERE 36.5 HEALTH CARE PROVIDER FTES WHO DELIVERED THE SERVICES DURING THE YEAR.THE CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUES OR SHOWN AS GRANTS TO INDIVIDUALS.THE CENTER MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE THAT IT PROVIDES. THE COSTS ASSOCIATED WITH THE CHARITABLE CARE SERVICES PROVIDED ARE ESTIMATED BY APPLYING THE COST-TO-CHARGE RATIO FROM THE MOST RECENTLY FILED COST REPORT TO THE AMOUNT OF GROSS UNCOMPENSATED CHARGES FOR THE PATIENTS RECEIVING CHARITY CARE. TOTAL CHARITY CARE COSTS WERE $1,057,758 FOR THE YEAR ENDED DECEMBER 31, 2022. 14418995 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 0 0 0 0 1 28 0 102 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X BENITO LINDO CFO 7189242254 439 PORT RICHMOND AVE STATEN ISLAND NY 10302 JACK DE SANTIS JR CPA PRESIDENT 1.00 0.00 X X 0 0 0 SHERIF FARAG MD 1ST VICE PRESIDENT 1.00 0.00 X X 0 0 0 TIFFANY ARGUELLO 2ND VICE PRESIDENT 1.00 0.00 X X 0 0 0 SANDHYA NADADUR SECRETARY 1.00 0.00 X X 0 0 0 DEMETRIUS CAROLINA TREASURER 1.00 0.00 X X 0 0 0 MICHAEL PERRY MEMBER 1.00 0.00 X 0 0 0 BARBARA HART MEMBER 1.00 0.00 X 0 0 0 KIM HINKSON MEMBER 1.00 0.00 X 0 0 0 COLEEN MURTHA MEMBER 1.00 0.00 X 0 0 0 HENRY THOMPSON CHIEF EXECUTIVE OFFICER 40.00 0.00 X 391850 0 65568 BENITO LINDO CHIEF FINANCIAL OFFICER 40.00 0.00 X 258302 0 33561 ROSALINDA ROSARIO-LIPKA DO CHIEF MEDICAL OFFICER 30.00 0.00 X 242442 0 35715 MONIQUE WELBECK DNP CHIEF NURSING OFFICER 40.00 0.00 X 247472 0 32924 CARY ENGLISH PHYSICIAN 40.00 0.00 X 212925 0 17592 GERARD CASALE PHYSICIAN 40.00 0.00 X 211357 0 38657 SEIN THAN PHYSICIAN 40.00 0.00 X 205243 0 25323 PREETI SHETKAR PHYSICIAN 40.00 0.00 X 195515 0 52044 1965106 0 301384 25 0 1 0 HENRICH GROUP LLC 125-28 QUEENS BLVD SUITE 617 KEW GARDENS NY 11415 CONSTRUCTION MGMT 144050 BRANDSISTERS LLC 7 OAK PLACE SUITE 260 MONTCLAIR NJ 07042 SOCIAL MEDIA MGMNT SERVICES 107633 2 8218433 356053 407678 8574486 NET PATIENT SVC REV 623000 7531984 7531984 PHARMACY SALES AT COST 623000 1602846 1602846 9134830 158 158 PATIENT INCENTIVE REVENUE 900099 493716 493716 MEDICAL RECORDS REVENUE 900099 7334 7334 MISCELLANEOUS INCOME 900099 60 60 501110 18210584 9134830 0 501268 1027438 291863 735575 7356917 6608241 748676 724051 640034 84017 1698742 1195219 503523 559957 466084 93873 237509 197693 39816 60349 50232 10117 987625 879959 107666 24899 6723 18176 2191283 2006688 184595 82486 68934 13552 706809 692713 14096 126070 70156 55914 352428 281942 70486 709053 568144 140909 120252 99484 20768 REPAIRS AND MAINTENANCE 143862 115272 28590 DUES AND SUBSCRIPTIONS 75551 46244 29307 TRAINING EXPENSES 61115 49844 11271 BDCC SURCHARGE 54053 54053 134827 83526 51301 17435276 14418995 3016281 0 350 350 1327339 1028657 130606 327186 1004492 1436290 86264 145709 27338458 7618738 19559608 19719720 85936 85936 31497 2925346 22226092 25669194 822783 1270673 135027 277993 6633508 5818874 0 3175250 7591318 10542790 X 14634774 15126404 14634774 15126404 22226092 25669194 X 775308 -283678 X 0 1 X 1 1 1 X 6099115 6941794 7596369 9893131 8574486 39104895 7960856 9046196 8043726 9226878 9134830 43412486 14059971 15987990 15640095 19120009 17709316 82517381 0 0 0 82517381 2235 1998 1509 647 158 6547 2235 1998 1509 647 158 6547 1269960 942957 1093122 396607 501110 4203756 15332166 16932945 16734726 19517263 18210584 86727684 0.95150 0.94930 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2018 AMOUNT: $ 57,196. 2019 AMOUNT: $ 3,500. 2022 AMOUNT: $ 60. MEDICAL RECORDS - 2018 AMOUNT: $ 3,589. 2019 AMOUNT: $ 15,573. 2020 AMOUNT: $ 6,213. 2021 AMOUNT: $ 3,816. 2022 AMOUNT: $ 7,334. INCENTIVE PROGRAM - 2018 AMOUNT: $ 479,248. 2019 AMOUNT: $ 254,151. 2020 AMOUNT: $ 510,144. 2021 AMOUNT: $ 275,882. 2022 AMOUNT: $ 493,716. DSRIP INCENTIVE - 2018 AMOUNT: $ 729,927. 2019 AMOUNT: $ 626,706. 2020 AMOUNT: $ 576,765. 2021 AMOUNT: $ 99,000. CHIPA PARTNERSHIP - 2019 AMOUNT: $ 43,027. 2021 AMOUNT: $ 17,909. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9133863 9133863 13867537 6072836 7794701 1890379 1545902 344477 2446679 2446679 19719720 SECURITY DEPOSITS 31497 RIGHT OF USE OPERATING LEASE 2893849 2925346 OPERATING LEASES 3175250 3175250 X 18190035 -20549 -20549 18210584 0 18210584 17414727 0 17414727 20549 20549 17435276 PART X, LINE 2: THE CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2022 AND 2021. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISON FOR BAD DEBTS NETTED AGAINST REVENUE -20,549. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISON FOR BAD DEBTS NETTED AGAINST REVENUE 20,549. X X 0 0 0 0 0 0 0 0 0 HENRY THOMPSON CHIEF EXECUTIVE OFFICER 391850 0 0 0 0 0 30970 0 34598 0 457418 0 0 0 BENITO LINDO CHIEF FINANCIAL OFFICER 258302 0 0 0 0 0 21421 0 12140 0 291863 0 0 0 MONIQUE WELBECK DNP CHIEF NURSING OFFICER 247472 0 0 0 0 0 20784 0 12140 0 280396 0 0 0 ROSALINDA ROSARIO-LIPKA DO CHIEF MEDICAL OFFICER 242442 0 0 0 0 0 18235 0 17480 0 278157 0 0 0 GERARD CASALE PHYSICIAN 211357 0 0 0 0 0 18092 0 20565 0 250014 0 0 0 PREETI SHETKAR PHYSICIAN 195515 0 0 0 0 0 17446 0 34598 0 247559 0 0 0 SEIN THAN PHYSICIAN 205243 0 0 0 0 0 13183 0 12140 0 230566 0 0 0 CARY ENGLISH PHYSICIAN 212925 0 0 0 0 0 17592 0 0 0 230517 0 0 0 X 2 407678 COST 0 0 1 0 PART I, COLUMN (B): THE AMOUNT REPORTED IN COLUMN B OF SCHEDULE M REPRESENTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B THE CEO AND CFO REVIEW THE FORM 990 BEFORE IT IS FILED. THE RETURN IS THEN PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW AND THEN TO THE GENERAL BOARD FOR APPROVAL BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C CHCR PROVIDES BOARD MEMBERS AND STAFF WITH A CONFLICT OF INTEREST STATEMENT WHICH SUMMARIZES THE KEY ELEMENTS OF THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. THE STATEMENT IS PROVIDED TO AND SIGNED BY BOARD MEMBERS AND STAFF BOTH AT THE TIME OF THE INDIVIDUAL'S INITIAL AFFILIATION WITH THE ORGANIZATION AND ANNUALLY THEREAFTER. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED IN THE POLICY. THE CEO IS RESPONSIBLE FOR MONITORING THE CONFLICTS. THE BOARD OF DIRECTORS REVIEWS THE CEO'S ANNUAL CONFLICT OF INTEREST STATEMENT. IN THE CASE OF A CONFLICT OF INTEREST, THE BOARD MEMBER WILL REPORT THE CONFLICT TO THE FULL BOARD PRIOR TO ANY DISCUSSION OF THE MATTER AND RECUSE THEMSELVES FROM VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 OFFICER COMPENSATION IS DETERMINED AND COMPARED BASED ON THE CURRENT MARKET, INDUSTRY STANDARDS AND SURVEYS TAKEN. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS APPROVES THE CHIEF EXECUTIVE OFFICER'S SALARY. THE COMPENSATION SETTING PROCESS IS DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES. THIS PROCESS IS THEN DONE WITH THE GOAL OF ENSURING A SALARY OF NO MORE THAN THE FAIR MARKET VALUE OF THE SERVICES RENDERED. SALARIES FOR THE OTHER OFFICERS AND STAFF ARE BASED UPON AN INDUSTRY SURVEY, E.G. NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC), AND THE COMMUNITY HEALTH CENTER ASSOCIATION OF NEW YORK STATE (CHCANYS). THE ORGANIZATION HAS A BOARD PERSONNEL COMMITTEE THAT OVERSEES HIRING AND CREDENTIALING OF EMPLOYEES. THE CEO HAS THE PRIVILEGE AND SOLE AUTHORITY TO HIRE AND FIRE EMPLOYEES; TO ESTABLISH SALARIES BASED UPON THE SURVEY PARAMETERS, AND TO PROVIDE RECOMMENDATIONS TO THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: ADOPTION OF TOPIC 842 -283,678.