2024-05-14T10:24:58-05:00 2023-06-30 111986323 MARCUM LLP 555 LONG WHARF DRIVE NEW HAVEN CT 06511 990 2022-07-01 061436620 NORWALK COMMUNITY HEALTH CENTER NORW 2038991770 120 CONNECTICUT AVENUE NORWALK CT 06854 KENNETH WALLER CHIEF EXECUTIVE OFFICER 2038991770 2024-05-13 1 KENNETH WALLER 999009999 0 MARY ANTONETTI P00431862 2037819600 2024-05-09 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z KENNETH WALLER 120 CONNECTICUT AVENUE NORWALK CT 06854 13849882 0 X WWW.NORWALKCHC.ORG X 1999 CT TO PROVIDE QUALITY, INNOVATIVE CARE THAT ENRICHES THE LIVES OF OUR PATIENTS. 11 11 135 11 0 0 7076973 6986514 6637201 6773710 2629 2633 76077 87025 13792880 13849882 0 0 0 0 8572157 9176951 0 0 0 4651147 4634831 13223304 13811782 569576 38100 6154083 11772877 2754286 8334980 3399797 3437897 TO PROVIDE QUALITY, INNOVATIVE CARE THAT ENRICHES THE LIVES OF OUR PATIENTS. 0 0 11852291 6773710 TO ESTABLISH, DEVELOP, MAINTAIN, MANAGE AND OPERATE A NONPROFIT OUTPATIENT CLINIC PROVIDING COMPREHENSIVE PRIMARY CARE TO THE NORWALK, CT COMMUNITY. 11852291 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 20 0 1 135 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 CT X KENNETH WALLER CHIEF EXECUTIVE OFFICER 2038991770 120 CONNECTICUT AVENUE NORWALK CT 06854 ADRIANA FIELDS DIRECTOR 1.00 X 0 0 0 ALICIA BRIGGS DIRECTOR 1.00 X 0 0 0 DARLENE YOUNG VICE CHAIR 2.50 X X 0 0 0 JAMES WHITING TREASURER 2.50 X X 0 0 0 JOSEPH E MANN BOARD CHAIR 2.50 X X 0 0 0 LENORE JORDAN SECRETARY 2.50 X X 0 0 0 LISETTE FORD DIRECTOR 1.00 X 0 0 0 LUNDA ASMANI DIRECTOR 1.00 X 0 0 0 PETER KORZENIK DIRECTOR 1.00 X 0 0 0 THANA VAN ROOYEN DIRECTOR 1.00 X 0 0 0 YVONNE RODRIGUEZ DIRECTOR 1.00 X 0 0 0 JOHN J GETTINGS III CFO 40.00 X 182493 0 21828 KENNETH WALLER CEO 40.00 X 230358 0 0 DJANA HARP CMO 40.00 X 264738 0 15322 MERYL HERTZ DIRECTOR OF DENTAL 40.00 X 164956 0 29093 REBECCA KAPLAN DIRECTOR OF CLINICAL OPERA 40.00 X 167735 0 18190 ELIZABETH THOMAS PROVIDER 40.00 X 193376 0 13022 GERALDINE SIMPLICE PROVIDER 40.00 X 180788 0 26223 JILL GOLDBERG PROVIDER 40.00 X 143085 0 18101 MARY LUCIA PROVIDER 40.00 X 215944 0 6836 JEAN-MICHEL OQUET PROVIDER 40.00 X 212661 0 18101 1956134 0 166716 12 0 1 0 NORWALK HOSPITAL ASSOCIATION 24 STEVENS STREET NORWALK CT 06850 PRIMARY CARE MEDICAL PROVIDERS 615216 SALLY R BERGWERK MD 35 RIDGEFIELD ROAD PO BOX 725 WILTON CT 06897 PROVIDER 159706 2 4890804 2095710 679577 6986514 PATIENT SERVICES 621110 6773710 6773710 6773710 2633 2633 77512 0 77512 77512 77512 OTHER INCOME 900099 9513 9513 9513 13849882 6773710 0 89658 679750 257144 422606 7085812 6262405 823407 95267 76914 18353 715833 577931 137902 600289 499808 100481 21239 21239 33996 33996 1173783 1117033 56750 6693 6693 187450 168332 19118 389371 389371 933550 748800 184750 4815 4815 61094 61094 764 764 282845 237973 44872 VACCINES 679577 679577 CLINICAL SUPPLIES 198922 198922 REPAIRS & MAINTENANCE 160924 129916 31008 REAL ESTATE TAXES 151583 121869 29714 348225 312930 35295 13811782 11852291 1959491 0 3823145 1942484 1757043 75420 128917 521952 691787 106241 135232 4963747 3449918 1627325 1513829 0 5603585 6154083 11772877 855344 797671 40137 68509 1858805 7468800 2754286 8334980 X 3399797 3437897 3399797 3437897 6154083 11772877 38100 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3137437 1812604 1324833 1826310 1637314 188996 1513829 OPERATING LEASE RIGHT OF USE ASSET 5603585 5603585 DEFERRED LEASE LIABILITY 7468800 7468800 X 13849882 0 13849882 0 13849882 13811782 0 13811782 0 13811782 PART X, LINE 2: NCHC HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON BUSINESS RELATED INCOME. NCHC ACCOUNTS FOR UNCERTAIN TAX PROVISIONS UNDER FASB ASC 740, INCOME TAXES, WHICH PROVIDES A FRAMEWORK FOR HOW ENTITIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR FINANCIAL STATEMENTS. NCHC MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. NCHC DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2023 AND 2022. AS OF JUNE 30, 2023 AND 2022, NCHC DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. X X 0 0 0 0 0 0 0 1 0 DJANA HARP CMO 256726 0 8012 0 0 0 7875 0 7447 0 280060 0 0 0 JEAN-MICHEL OQUET PROVIDER 209665 0 2996 0 0 0 0 0 18101 0 230762 0 0 0 KENNETH WALLER CEO 209846 0 20512 0 0 0 0 0 0 0 230358 0 0 0 MARY LUCIA PROVIDER 213633 0 2311 0 0 0 0 0 6836 0 222780 0 0 0 GERALDINE SIMPLICE PROVIDER 173511 0 7277 0 0 0 3117 0 23106 0 207011 0 0 0 ELIZABETH THOMAS PROVIDER 191254 0 2122 0 0 0 5575 0 7447 0 206398 0 0 0 JOHN J GETTINGS III CFO 181986 0 507 0 0 0 6256 0 15572 0 204321 0 0 0 MERYL HERTZ DIRECTOR OF DENTAL 160926 0 4030 0 0 0 5986 0 23107 0 194049 0 0 0 REBECCA KAPLAN DIRECTOR OF CLINICAL OPERA 159184 0 8551 0 0 0 5670 0 12520 0 185925 0 0 0 JILL GOLDBERG PROVIDER 140919 0 2166 0 0 0 0 0 18101 0 161186 0 0 0 PART I, LINE 7 THE FOLLOWING EMPLOYEES RECEIVED PROVIDER INCENTIVE BONUS AS FOLLOWS ELIZABETH THOMAS $1,615 MERYL HERTZ $3,513 REBECCA KAPLAN $3,044 JEAN-MICHEL OQUET $2,484 MARIA LUCIA $1,799 JILL GOLDBERG $1,625 GERALDINE SIMPLICE $6,770 REBECCA KAPLAN RECEIVED A PERFORMANCE BONUS OF $5,000 EMPLOYMENT AGREEMENT BONUS PAID AS FOLLOWS: DJANA HARP $ 7,500 KENNETH WALLER $20,000 THE FOLLOWING EMPLOYEES RECEIVED A SMALL CHRISTMAS BONUS OF $507, $512 OR $541 EACH JOHN GETTINGS $507 ELIZABETH THOMAS $507 MERYL HERTZ $507 REBECCA KAPLAN $507 GERALDINE SIMPLICE $507 KENNETH WALLER $512 DJANA HARP $512 JEAN-MICHEL OQUET $512 MARIA LUCIA $512 JILL GOLDBERG $541 X 1 679577 FMV 0 0 0 PART I, COLUMN (B): SCHEDULE M PART 1 LINE 20 VACCINES: THE ORGANIZATION RECEIVED DONATED VACCINES THROUGHOUT THE YEAR. THE NUMBER LISTED IS ONE BECAUSE ALL VACCINES COME THROUGH ONE IMMUNIZATION GRANT. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE OF MANAGEMENT. A FINAL DRAFT OF THE RETURN IS REVIEWED AND FINALIZED BY THE CFO PRIOR TO DISTRIBUTION TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY WHICH PROHIBITS CONFLICT OF INTEREST OR THE APPEARANCE OF CONFLICT OF INTEREST BY BOARD MEMBERS, EMPLOYEES, AND THOSE WHO PROVIDE SERVICES OR FURNISH GOODS TO THE ORGANIZATION. ON AN ANNUAL BASIS, THE BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS REVIEW BY NCHC LEADERSHIP. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES BOARD APPROVED SALARY RANGES THAT UTILIZED DATA FROM NACHC, CHCACT, MGMA AND OTHER SOURCES TO DETERMINE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT AND STAFF. THE BOARD APPROVES THE COMPENSATION OF THE CEO, AND THE CEO HAS THE AUTHORITY TO APPROVE COMPENSATION OF ALL OTHER EMPLOYEES. SUCH APPROVAL IS DOCUMENTED IN THE BOARD MINUTES. 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.