2022-05-13T11:34:17-05:00 2021-06-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2020-07-01 237354899 CHESPENN HEALTH SERVICES INC CHES 6104853800 1510 CHESTER PIKE NO 200 EDDYSTONE PA 19022 DANIEL CAPLAN CHIEF FINANCIAL OFFICER 6104853800 2022-05-13 1 DANIEL CAPLAN XXX-XX-XXXX KERRI N BOGDA CPA P00760402 7177404863 X 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z DANIEL CAPLAN 1510 CHESTER PIKE NO 200 EDDYSTONE PA 19022 13786205 0 X WWW.CHESPENN.ORG X 1972 PA TO OPERATE THREE COMPREHENSIVE HEALTH CENTERS LOCATED IN CHESTER AND DELAWARE COUNTIES. 10 10 185 11 0 0 4232107 5764797 7874235 7939474 64029 81934 0 0 12170371 13786205 0 0 0 0 7088971 6710324 0 0 0 5742392 6217559 12831363 12927883 -660992 858322 7912700 8301423 2960142 2490543 4952558 5810880 X CHESPENN HEALTH SERVICES IS A NETWORK OF NON-PROFIT, FEDERALLY QUALIFIED HEALTH CENTERS THAT PROVIDES COMPREHENSIVE PRIMARY AND PREVENTIVE HEALTH CARE AND SOCIAL SERVICES TO MEDICALLY UNDERSERVED FAMILIES AND INDIVIDUALS ON A SLIDING SCALE. CHESPENN HEALTH SERVICES STRIVES TO MEET THE UNIQUE HEALTH NEEDS IN ITS COMMUNITIES IN LINGUISTICALLY AND CULTURALLY COMPETENT WAYS. 0 0 9430502 7939474 SINCE 1973, CHESPENN HEALTH SERVICES HAS PROVIDED COMPREHENSIVE FAMILY MEDICAL AND DENTAL CARE TO THE RESIDENTS OF CHESTER, PA AND NEIGHBORING COMMUNITIES. IN 2005, CHESPENN EXPANDED THESE HEALTH CARE SERVICES TO THE COATESVILLE AREA, AND IN 2009, CHESPENN OPENED THE CENTER FOR FAMILY HEALTH IN UPPER DARBY, PA. ADDITIONAL SERVICES THAT ARE OFFERED INCLUDE HEALTH CARE, FAMILY PLANNING SERVICES, OB/GYN, HIV/AIDS CARE, BEHAVIORAL HEALTH AND AN IN-HOUSE PHYSICIAN DISPENSARY. CHESPENN IS PRINCIPALLY FUNDED BY GRANTS FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. DURING THE 2020 TAX YEAR, CHESPENN RECEIVED TOTAL GRANT REVENUE OF $4,091,159.DURING THE 2020 TAX YEAR, CHESPENN HAD TOTAL BILLABLE ENCOUNTERS OF 49,407. THE BILLABLE ENCOUNTERS CONSISTED OF THE FOLLOWING IN CHESTER, PA: 6,094 PEDIATRIC ENCOUNTERS, 14,698 ADULT ENCOUNTERS, AND 3,539 DENTAL ENCOUNTERS. IN ADDITION, THERE WERE 11,131 MEDICAL ENCOUNTERS AT THE UPPER DARBY CENTER FOR FAMILY HEALTH AND 13,945 MEDICAL AND DENTAL ENCOUNTERS IN THE COATESVILLE SERVICE AREA. CHESPENN PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE AMOUNTS DETERMINED TO BE CHARITY CARE ARE NOT REPORTED AS REVENUES. DURING THE 2020 TAX YEAR, CHESPENN PROVIDED CHARITY CARE OF APPROXIMATELY $1,238,000 TO PATIENTS. 9430502 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 9 0 185 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X DANIEL A CAPLAN 6104853800 1510 CHESTER PIKE STE 200 EDDYSTONE PA 19022 WILLIE MAE WELLS PRESIDENT 1.00 0.00 X X 0 0 0 RAE ROEDER SECRETARY 1.00 0.00 X X 0 0 0 KAREN VESELY TREASURER 1.00 0.00 X X 0 0 0 CAROL ALLEN BOARD MEMBER 1.00 0.00 X 0 0 0 ANTHONY HALL BOARD MEMBER 1.00 0.00 X 0 0 0 DONNA LAWLER BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID KEITH BOARD MEMBER 1.00 0.00 X 0 0 0 JEFFREY GREEN BOARD MEMBER 1.00 0.00 X 0 0 0 GWEN SMITH BOARD MEMBER 1.00 0.00 X 0 0 0 DINA CAPALONGO BOARD MEMBER 1.00 0.00 X 0 0 0 GARY DAVIS PRESIDENT/CEO 40.00 0.00 X 153300 0 8239 DANIEL A CAPLAN CHIEF FINANCIAL OFFICER 40.00 0.00 X 138760 0 16554 KEVIN MCCABE MD PHYSICIAN 40.00 0.00 X 193086 0 10947 NEERAJA PERI MD PHYSICIAN 40.00 0.00 X 180174 0 13159 RAQUIBUL ISLAM MD PHYSICIAN 40.00 0.00 X 172576 0 18417 TINA AHMADINEJAD MD PHYSICIAN 40.00 0.00 X 179147 0 15364 BRUCE AUDEN MD PHYSICIAN 40.00 0.00 X 167929 0 20717 MICHAEL G LUCAS FORMER PRES/CEO TO 4/18/20 0.00 0.00 X 152266 0 4576 1337238 0 107973 17 1 1 0 PROSPECT HEALTH ACCESS NETWORK ONE MEDICAL CENTER BLVD UPLAND PA 19013 CONTRACTED PHYSICIAN SERVICES 1526019 CALL 4 HEALTH 2855 S CONGRESS AVENUE DELRAY BEACH FL 33445 CALL CENTER SERVICE 366144 VIRTUAL OFFICEWARE HC SOLUTIONS 2000 CLIFF MINE RD STE 510 PITTSBURGH PA 15275 INFORMATION TECHNOLOGY & SRVS 355680 COORDINATED CARE NETWORK 300 PENN CENTER BLVD PITTSBURGH PA 15235 CONTRACTED PHARMACY SERVICES 348288 PENN MEDICINE CHESTER COUNTY HOSPITAL 701 EAST MARSHALL STREET WEST CHESTER PA 19380 CONTRACTED PHYSICIAN SERVICES 173777 8 26540 4889834 848423 5764797 NET PATIENT SERVICE REVENUE 621400 7939474 7939474 7939474 81934 81934 13786205 7939474 0 81934 X 372417 372417 5352803 3943676 1409127 219704 174493 45211 330361 238233 92128 435039 302268 132771 4185 4185 62430 13244 49186 2490026 2247008 243018 12275 12275 629895 468252 161643 580254 7326 572928 939550 744444 195106 68837 8620 60217 27867 27867 94345 94345 50666 25498 25168 PATIENT CARE 728856 721036 7820 EQUIPMENT RENTAL 260686 244820 15866 PROVISION FOR DOUBTFUL 182472 182472 DUES AND SUBSCRIPTIONS 48887 7976 40911 36328 6791 29537 12927883 9430502 3497381 0 302505 317890 5732499 6222414 198430 67992 458404 423521 12532 7881 84445 54698 5171212 3964185 1123885 1207027 7912700 8301423 1374877 1492089 83333 359910 1292391 465885 209541 172659 2960142 2490543 X 4952558 5810880 4952558 5810880 7912700 8301423 858322 0 X 0 1 X 1 0 X 3990080 3721480 3554740 4232107 5764797 21263204 7234651 8233321 8642475 7874235 7939474 39924156 11224731 11954801 12197215 12106342 13704271 61187360 0 0 0 61187360 6672 21900 71918 64029 81934 246453 6672 21900 71918 64029 81934 246453 11231403 11976701 12269133 12170371 13786205 61433813 0.99600 0.99720 0.00400 0.00280 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 100838 100838 3153067 2230299 922768 349794 349794 0 1341554 1335620 5934 225959 48472 177487 1207027 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 172659 172659 X 13786205 0 13786205 0 13786205 12927883 0 12927883 0 12927883 PART X, LINE 2: THE CORPORATION 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 IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2021 AND 2020. X X X 0 0 0 0 0 0 0 0 0 KEVIN MCCABE MD PHYSICIAN 192786 0 300 0 0 0 9654 0 1293 0 204033 0 0 0 TINA AHMADINEJAD MD PHYSICIAN 178847 0 300 0 0 0 9059 0 6305 0 194511 0 0 0 NEERAJA PERI MD PHYSICIAN 179874 0 300 0 0 0 9059 0 4100 0 193333 0 0 0 RAQUIBUL ISLAM MD PHYSICIAN 172276 0 300 0 0 0 9043 0 9374 0 190993 0 0 0 BRUCE AUDEN MD PHYSICIAN 167629 0 300 0 0 0 9015 0 11702 0 188646 0 0 0 GARY DAVIS PRESIDENT/CEO 151000 0 2300 0 0 0 7665 0 574 0 161539 0 0 0 MICHAEL G LUCAS FORMER PRES/CEO TO 4/18/20 152266 0 0 0 0 0 3830 0 746 0 156842 0 0 0 DANIEL A CAPLAN CHIEF FINANCIAL OFFICER 138460 0 300 0 0 0 7214 0 9340 0 155314 0 0 0 SCHEDULE J PART II, COLUMN BIII BONUSES IN COLUMN BIII RELATE TO BONUSES APPROVED BY A FEDERAL COVID GRANT FOR ATTENDANCE DURING THE PANDEMIC. FORM 990, PART VI, SECTION A, LINE 1 KEY FINANCIAL DECISIONS AND REPORTS ARE APPROVED BY THE FINANCE COMMITTEE AND THEN PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. MEMBERS OF THE FINANCE COMMITTEE ARE ALSO MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FINAL 990 RETURN WAS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE ALONG WITH THE BOARD OF DIRECTORS OF CHESPENN HEALTH SERVICES. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS MUST ANNUALLY SIGN THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS ARE ALSO REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST THAT MAY ARISE DURING THE YEAR AND MUST REFRAIN FROM DISCUSSING, AS WELL AS VOTING ON, SUCH MATTERS THAT PERTAIN TO THE CONFLICT. EMPLOYEES OF THE ORGANIZATION ARE ALSO REQUIRED TO REPORT ANY POTENTIAL OR ACTUAL CONFLICT TO THE PRESIDENT/CEO. THE PRESIDENT/CEO IS RESPONSIBLE FOR MONITORING AND RESOLVING ANY CONFLICT OF INTEREST THAT MAY ARISE WITHIN THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 TO DETERMINE THE SALARY OF THE PRESIDENT/CEO, CHESPENN HEALTH SERVICES RELIES ON SURVEY INFORMATION FROM TWO SOURCES. THE FIRST SOURCE IS AN ANNUAL SURVEY CONDUCTED BY THE HOSPITAL AND THE HEALTHCARE COMPENSATION SERVICE FOR THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS WHICH CATEGORIZES ALL COMMUNITY HEALTH CENTERS BY SERVICE LEVEL, GEOGRAPHY AND BUDGET. THE SECOND SOURCE IS THE IRS FORM 990 IN WHICH A COMPENSATION SURVEY OF REGIONAL COMMUNITY HEALTH CENTERS IS CONDUCTED. BOTH SOURCES OF INFORMATION ARE USED BY CHESPENN HEALTH SERVICES' BOARD OF DIRECTORS TO DETERMINE THE COMPENSATION LEVEL. THIS COMPENSATION REVIEW IS CONDUCTED ON AN ANNUAL BASIS TO ASSURE THAT COMPENSATION IS IN LINE WITH FAIR MARKET VALUE, AND THE PROCESS IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIANS, DENTAL, INTERPRETING: PROGRAM SERVICE EXPENSES 2,247,008. MANAGEMENT AND GENERAL EXPENSES 243,018. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,490,026.