2024-04-25T00:41:41-05:00 2023-06-30 221478099 COHNREZNICK LLP 14 SYLVAN WAY PARSIPPANY NJ 070543801 990 2022-07-01 060883545 FAIR HAVEN COMMUNITY HEALTH CLINIC INC FAIR 2037777411 374 GRAND AVENUE NEW HAVEN CT 06513 SUZANNE LAGARDE MD MBA FACP CEO 2037777411 2024-04-23 1 SUZANNE LAGARDE MD MBA FACP 999009999 0 LORI ROTHE YOKOBOSKY CPA P01273422 9732283500 2024-03-26 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z SUZANNE LAGARDE MD MBA F 374 GRAND AVENUE NEW HAVEN CT 06513 52904460 0 X WWW.FHCHC.ORG X 1971 CT NON-PROFIT PRIMARY HEALTH CARE ORGANIZATION SERVING THE GREATER FAIR HAVEN COMMUNITY SINCE 1971. OUR MISSION IS TO PROVIDE EXCELLENT, ACCESSIBLE CARE TO THE MEDICALLY UNDER-SERVED, REGARDLESS OF THEIR ABILITY TO PAY. 12 12 335 13 -96934 0 14679453 20013491 22150555 29435265 70826 -1272407 179840 143017 37080674 48319366 0 2375914 0 0 19639242 23248384 0 0 139746 15067264 15969312 34706506 41593610 2374168 6725756 26329071 58336591 5651851 30872693 20677220 27463898 NON-PROFIT PRIMARY HEALTH CARE ORGANIZATION SERVING THE GREATER FAIR HAVEN COMMUNITY SINCE 1971. OUR MISSION IS TO PROVIDE EXCELLENT, ACCESSIBLE CARE TO THE MEDICALLY UNDER-SERVED, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 29937308 1130179 29675216 THE CLINIC EXPERIENCED 111,604 MEDICAL RELATED PATIENT VISITS, 17,958 MENTAL HEALTH RELATED VISITS, AND 5,241 DENTAL VISITS FOR THE FISCAL YEAR JUNE 30, 2023. 1245735 1245735 WIC PROGRAM PROVIDED NUTRITION EDUCATION AND FOOD BENEFITS FOR PREGNANT AND LACTATING WOMEN, INFANTS, AND CHILDREN UNDER THE AGE OF FIVE. APPROXIMATELY 7,950 PEOPLE BENEFITED FROM THIS PROGRAM. 31183043 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 62 0 1 335 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X SUZANNE LAGARDE MD MBA FACP 2037777411 374 GRAND AVENUE NEW HAVEN CT 06513 ANDREA SIMMONS VICE PRESIDENT 1.00 X X 0 0 0 CARLA WEIL BOARD MEMBER 1.00 1.00 X 0 0 0 ENRIQUE JUNCADELLA BOARD MEMBER 1.00 X 0 0 0 EVELYN BARNUM BOARD MEMBER 1.00 X 0 0 0 JOHN DESTEFANO JR BOARD MEMBER 1.00 X 0 0 0 MAGDA ANA NATAL SECRETARY 1.00 X X 0 0 0 MALWIN DAVILA BOARD MEMBER 1.00 X 0 0 0 MARIBEL MARTINEZ PRESIDENT 1.00 1.00 X X 0 0 0 NITZA DIAZ BOARD MEMBER 1.00 X 0 0 0 RICHARD D'AQUILA OUTGOING BOARD MEMBER 1.00 X 0 0 0 RUTH RODRIGUEZ BOARD MEMBER 1.00 X 0 0 0 TOM CANDRICK ESQ TREASURER 1.00 X X 0 0 0 WILLIAM MORICO BOARD MEMBER 1.00 X 0 0 0 ABIGAIL PAINE VP PROGRAMS 40.00 X 187378 0 3508 AMY TRIMANI CHIEF FINANCIAL OFFICER 39.00 1.00 X 199984 0 3723 BENJAMIN OLDFIELD VP CLINICAL AFFAIRS 40.00 X 291589 0 13701 S DOMINIC SERAPHIN VP BUSINESS DEVELOPMENT 40.00 X 184071 0 42090 SUZANNE LAGARDE CHIEF EXECUTIVE OFFICER 39.00 1.00 X 291965 0 1568 THERESE MARROCCO VP ADMINISTRATIVE SERVICES 40.00 X 198319 0 30055 JAMES SEELY MD 40.00 X 219250 0 12421 JOHN MCDONAGH MD 40.00 X 213372 0 43914 KARLA TEJADA ARIAS MD 40.00 X 202883 0 35103 KYLE ELLIGERS MD 36.00 X 201200 0 12307 LACEY WHITMIRE MD 40.00 X 206397 0 9228 2396408 0 207618 44 0 1 0 E4H ENVIRONMENTS FOR HEALTH LLC 185 TALCOTT DRIVE WILLISTON VT 05495 ARCHITECTS 752469 BHCARE INC 127 WASHINGTON AVE NORTH HAVEN CT 06473 BEHAVIORAL HEALTH 666351 SHIPMAN & GOODWIN LLP ONE CONSTITUTION PLAZA HARTFORD CT 06103 LEGAL 149771 SSC INC 25 CONTROLS DRIVE SHELTON CT 06484 SECURITY SERVICE 135152 CHAMPION MAINTENANCE & CONSTRUCTION 301 COMMERCE DRIVE FAIRFIELD CT 06825 CLEANING SERVICE 129123 11 1891700 15508892 2612899 3779794 20013491 MEDICAID 621400 20632082 20632082 340B PHARMACY REVENUE 621400 6095044 6095044 THIRD-PARTY PAYORS 621400 1893290 1893290 SELF-PAY 621400 495249 495249 MEDICARE 621400 319600 319600 29435265 139728 139728 135547 232481 -96934 -96934 -96934 2940478 2933663 1418950 6815 -1418950 -1412135 -1412135 239951 239951 239951 48319366 29675216 -96934 -1272407 X 1130179 1130179 1245735 1245735 1502276 997542 496312 8422 18176111 12066911 6007254 101946 172793 115183 56649 961 1861687 1240991 610338 10358 1535517 1023568 503406 8543 186553 186553 77430 77430 20250 20250 4756594 3997895 758699 102162 92832 9330 502705 403093 99426 186 324939 230707 94232 1710552 1145486 565066 111607 104686 6921 83793 29692 54101 229210 96300 132910 967331 673486 293845 85084 81413 3671 340B PRESCRIPTION PROGR 3565272 3565272 DONATED VACCINES 2534059 2534059 MEDICAL SUPPLIES 459972 459972 EQUIPMENT AND VEHICLE M 80747 3092 77655 171052 37781 133271 41593610 31183043 10270821 139746 11072977 10018885 2404653 6424105 1257722 1149909 1432232 2397313 27654100 196817 129092 133263 17477782 8851812 9949062 8625970 83333 83333 1215562 0 437334 26329071 58336591 2789771 5062200 1186704 197092 1675376 24196306 0 1417095 5651851 30872693 X 20677220 27463898 20677220 27463898 26329071 58336591 6725756 60922 0 X 0 1 X 1 1 1 X 13067206 17655757 17118088 14679453 20013491 82533995 13067206 17655757 17118088 14679453 20013491 82533995 82533995 17004 51894 35913 16863 139728 261402 66643 256119 255869 239951 818582 83613979 90087697 0.98710 0.99060 X 0.99910 SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2019 AMOUNT: $ 66,643. 2020 AMOUNT: $ 256,119. 2021 AMOUNT: $ 255,869. 2022 AMOUNT: $ 239,951. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 20000 20000 0 PART II-B, LINE 1: $20,000 WAS PAID TO A CONSULTING FIRM FOR LOBBYING SERVICES RELATED TO LEGISLATION THAT AFFECTS FEDERALLY QUALIFIED HEALTH CENTERS. 478454 478454 7716368 5111308 2605060 5046496 2313631 2732865 3347296 1426873 1920423 889168 889168 8625970 OPERATING LEASE LIABILITIES 1404463 SECURITY DEPOSITS 12632 1417095 X 47970791 60922 1249163 -1891141 -581056 48551847 -232481 -232481 48319366 42036522 1249163 -806251 442912 41593610 0 41593610 PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CLINIC AND HAS CONCLUDED THAT, AS OF JUNE 30, 2023 THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CLINIC'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO YEAR 2020 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION REVENUE 1,259,849. INTERCOMPANY ELIMINATIONS -3,150,990. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSE OFFSET -232,481. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION EXPENSES 2,112,258. INTERCOMPANY ELIMINATIONS -3,150,990. RENTAL EXPENSE OFFSET 232,481. 1 FHCHC SUPPORT CORPORATION 374 GRAND AVENUE NEW HAVEN CT 06513 922404114 501(C)(3) 1130179 0 TO SUPPORT THE ORGANIZATION'S MISSION. 1 WIC-FOOD VOUCHERS 1332 1245735 FMV FOOD VOUCHERS PART I, LINE 2: CONTRIBUTION ASSISTANCE TO ORGANIZATION, IS TO AN AFFILIATE. THEREFORE, THE BOARD IS ABLE TO MONITOR USE OF FUNDS. FOR THE WIC-FOOD VOUCHER ASSISTANCE PROGRAM THE ORGANIZATION VERIFIES ELIGIBILITY BASED ON INDIVIDUALS INCOME TO PARTICPATE IN THE PROGRAM. PROOF OF INCOME IS PROVIDED THROUGH ONE OF THE FOLLOWING WAYS: HUSKY A OR HUSKY B PRENATAL MEDICAID CARDS, APPROVAL/BUDGET LETTER FOR SNAP OR TFA (TEMPORARY FAMILY ASSISTANCE), 4 CURRENT PAY STUBS FOR ALL WORKING HOUSEHOLD MEMBERS (PAYSTUBS CANNOT BE GREATER THAN 60 DAYS). RECIPIENTS OF SNAP, TFA OR HUSKY A/B CLIENTS ARE AUTOMATICALLY ELIGIBLE AS THEY MUST MEET THE SAME INCOME REQUIREMENTS TO RECEIVE THOSE BENEFITS. X 0 0 0 0 0 0 0 0 0 BENJAMIN OLDFIELD VP CLINICAL AFFAIRS 291589 0 0 0 0 0 318 0 13383 0 305290 0 0 0 SUZANNE LAGARDE CHIEF EXECUTIVE OFFICER 291965 0 0 0 0 0 1568 0 0 0 293533 0 0 0 JOHN MCDONAGH MD 213372 0 0 0 0 0 4561 0 39353 0 257286 0 0 0 KARLA TEJADA ARIAS MD 202883 0 0 0 0 0 4320 0 30783 0 237986 0 0 0 JAMES SEELY MD 219250 0 0 0 0 0 1099 0 11322 0 231671 0 0 0 THERESE MARROCCO VP ADMINISTRATIVE SERVICES 198319 0 0 0 0 0 3975 0 26080 0 228374 0 0 0 S DOMINIC SERAPHIN VP BUSINESS DEVELOPMENT 184071 0 0 0 0 0 4052 0 38038 0 226161 0 0 0 LACEY WHITMIRE MD 206397 0 0 0 0 0 4228 0 5000 0 215625 0 0 0 KYLE ELLIGERS MD 201200 0 0 0 0 0 0 0 12307 0 213507 0 0 0 AMY TRIMANI CHIEF FINANCIAL OFFICER 199984 0 0 0 0 0 3723 0 0 0 203707 0 0 0 ABIGAIL PAINE VP PROGRAMS 187378 0 0 0 0 0 3508 0 0 0 190886 0 0 0 X 1 1245735 FMV X 2 2534059 FMV 0 0 0 PART I, COLUMN (B): COLUMN B REPRESENTS NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY MANAGEMENT AND THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C ANY POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED AND RESOLVED BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD. OTHER OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION C, LINE 19 THEY ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER CONSULTANTS: PROGRAM SERVICE EXPENSES 3,997,895. MANAGEMENT AND GENERAL EXPENSES 758,699. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,756,594. 87 WOOLSEY STREET LLC 374 GRAND AVENUE NEW HAVEN CT 06513 HOLDING COMPANY CT 9900 0 FAIR HAVEN COMMUNITY HEALTH CLINIC INC 382-394 GRAND AVENUE LLC 374 GRAND AVENUE NEW HAVEN CT 06513 HOLDING COMPANY CT 125647 0 FAIR HAVEN COMMUNITY HEALTH CLINIC INC FHCHC SUPPORT CORPORATION 374 GRAND AVENUE NEW HAVEN CT 06513 922404114 SUPPORT FAIR HAVEN COMMUNITY HEALTH CLINIC, INC. CT 501(C)(3) LINE 12A, I FAIR HAVEN COMMUNITY HEALTH CLINIC INC 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 FHCHC SUPPORT CORPORATION B 1130179 FMV FHCHC SUPPORT CORPORATION C 1891700 FMV