CODMAN SQUARE HEALTH CENTER INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- CODMAN SQUARE HEALTH CENTER INC (EIN 04-2678774)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-16
- IRS object ID
- 202102289349300445
- Schema version
- 2019v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-08-16T08:50:04-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 042571780 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AAFCPAS INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 WASHINGTON STREET | AddressLine1Txt |
| City | WESTBOROUGH | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01581 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042678774 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CODMAN SQUARE HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CODM | BusinessNameControlTxt |
| Phone | 6178259660 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 637 WASHINGTON STREET | AddressLine1Txt |
| City | DORCHESTER | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02124 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SANDRA COTTERELL | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6178259660 | PhoneNum |
| Signature | 2021-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SORIE KABA CPA | PreparerPersonNm |
| PTIN | P01317106 | PTIN |
| Phone | 5083669100 | PhoneNum |
| Preparation | 2021-08-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SANDRA COTTERELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 637 WASHINGTON STREET | AddressLine1Txt |
| City | DORCHESTER | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02124 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $41,284,129 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CODMAN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE AS A RESOURCE FOR IMPROVING THE PHYSICAL, MENTAL AND SOCIAL WELL-BEING OF THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 400 | TotalEmployeeCnt |
| Total Volunteers | 88 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,323,827 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,307,993 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $33,127,156 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $31,444,304 | CYProgramServiceRevenueAmt |
| PY Investment Income | $196,422 | PYInvestmentIncomeAmt |
| CY Investment Income | $274,487 | CYInvestmentIncomeAmt |
| PY Other Revenue | $325,024 | PYOtherRevenueAmt |
| CY Other Revenue | $469,979 | CYOtherRevenueAmt |
| PY Total Revenue | $40,972,429 | PYTotalRevenueAmt |
| CY Total Revenue | $40,496,763 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,401,174 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $22,679,367 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $43,182 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $43,182 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,968,838 | PYOtherExpensesAmt |
| CY Other Expenses | $17,294,122 | CYOtherExpensesAmt |
| PY Total Expenses | $40,370,012 | PYTotalExpensesAmt |
| CY Total Expenses | $40,016,671 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $602,417 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $480,092 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $39,258,119 | TotalAssetsBOYAmt |
| Total Assets EOY | $52,055,151 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,178,764 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,655,128 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $33,079,355 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $35,400,023 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SERVE AS A RESOURCE FOR IMPROVING THE PHYSICAL, MENTAL AND SOCIAL WELL-BEING OF THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,580,819 | ExpenseAmt |
| Revenue | $13,102,396 | RevenueAmt |
| Desc | THE LARGEST PROGRAM BY EXPENSE IS OUR PRIMARY CARE DEPARTMENT. THIS IS THE BACKBONE OF OUR PATIENT CENTERED MEDICAL HOME EFFORTS. PROVIDERS CARE FOR PATIENTS THROUGHOUT ALL STAGES OF LIFE, INCLUDING BOTH WELLNESS APPOINTMENTS AND VISITS REQUIRING ATTENTION TO A SPECIFIC ILLNESS OR INJURY. THE HEALTH CENTER CARES FOR BOTH THE INDIVIDUAL AND HIS/HER FAMILY THROUGH THE INTEGRATION OF BIOLOGICAL, CLINICAL AND BEHAVIORAL SCIENCES. OUR APPROACH IS INTEGRATED AND HOLISTIC, AND ADDRESSES BOTH THE CLINICAL AND NON-CLINICAL (SOCIAL SERVICES, COMMUNITY BASED PROGRAMS). WHEN SPECIALTY SERVICES ARE NEEDED WE COORDINATE THAT CARE. THE HEALTH CENTER RECORDED 59,762 VISITS IN FY 2020. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,544,552 | ExpenseAmt |
| Revenue | $953,414 | RevenueAmt |
| Desc | OUR DENTAL DEPARTMENT PROVIDES PREVENTATIVE AND RESTORATIVE TREATMENT. THIS INCLUDES EXAMS, CLEANINGS, FILLINGS, ROOT CANAL TREATMENT, CROWNS, AND ORAL SURGERY PROCEDURES. OUR STATE-OF-THE-ART DENTAL CLINIC HAS 7 DENTAL OPERATORIES FULLY EQUIPPED WITH DIGITAL RADIOGRAPHY & AUTOMATIC DENTAL CHAIRS. WE ALSO HAVE A PEDIATRIC DENTAL SUITE EMBEDDED IN THE PEDIATRIC DENTAL CLINIC, DESIGNED SPECIFICALLY FOR PEDIATRIC DENTAL CARE. DENTRIX IS THE DENTAL PRACTICE MANAGEMENT SOFTWARE SYSTEM UTILIZED IN THE PRACTICE TO STORE DIGITAL X-RAYS, INTRAORAL PICTURES, PATIENT MEDICAL HISTORY, CLINICAL NOTES AND DENTAL BENEFIT INFORMATION. THE DENTAL STAFF INCLUDES GENERAL DENTISTS, HYGIENISTS, A PERIODONTIST (GUM SPECIALIST) AND ENDODONTIST (ROOT CANAL SPECIALIST). TREATMENT IS AVAILABLE TO ALL MEMBERS IN THE COMMUNITY INCLUDING UNINSURED PATIENTS, PATIENTS WITH MEDICAID, MEDICARE, MASS HEALTH, AS WELL AS COMMERCIALLY INSURED PATIENTS. WE ALSO SERVE AS AN EDUCATIONAL SITE FOR DENTAL STUDENT EXTERNS AND RESIDENTS FROM BOSTON UNIV., TUFTS UNIV. DENTAL SCHOOLS AND NYU LUTHERAN ADVANCED EDUCATION IN GENERAL DENTISTRY RESIDENCY PROGRAM. THE DENTAL DEPARTMENT RECORDED 5,961 VISITS IN FY 2020. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,902,796 | ExpenseAmt |
| Revenue | $3,670,967 | RevenueAmt |
| Desc | OUR URGENT CARE DEPARTMENT PROVIDES SAME DAY TREATMENT FOR ILLNESSES OR CONDITIONS THAT NEED IMMEDIATE ATTENTION. OUR STAFF IS COMPRISED OF PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, NURSES AND MEDICAL ASSISTANTS. URGENT CARE IS OFTEN A GATEWAY FOR PATIENTS TO BECOME A PART OF THE PATIENT CENTERED MEDICAL HOME, AND OUR STAFF IS TRAINED TO IDENTIFY THOSE INDIVIDUALS THAT NEED A PRIMARY CAREGIVER. URGENT CARE IS OPEN SEVEN DAYS A WEEK AND IS A KEY RESOURCE IN THE COMMUNITY TO ADDRESS URGENT NEEDS THAT SHOULD NOT REQUIRE A VISIT TO A HOSPITAL EMERGENCY ROOM. THE URGENT CARE DEPARTMENT RECORDED 16,475 VISITS IN FY 2020. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $20,465,124 | ExpenseAmt |
| Revenue | $14,130,818 | RevenueAmt |
| Desc | EYECARE, PATIENT SUPPORT SERVICES, PHARMACY, COMMUNITY SERVICES, MENTAL HEALTH AND OTHER CLINICAL SERVICES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $20,465,124 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $14,130,818 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $30,493,291 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 127 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 400 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | YI JUNG CFO | PersonNm |
| Phone | 6178259660 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 637 WASHINGTON STREET | AddressLine1Txt |
| City | DORCHESTER | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02124 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| SANDRA COTTERELL | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $280,971 | $0 | $45,470 | |||
| PHILIP SEVERIN | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $240,706 | $0 | $26,313 | 1.00 | ||
| STEPHENSON TOBIERRE | ||||||||
| PHYSICIAN | 47.13 | $216,858 | $0 | $25,216 | Yes (X) | |||
| STEPHEN TRINGALE | ||||||||
| PHYSICIAN | 40.00 | $210,793 | $0 | $12,488 | Yes (X) | |||
| SALVATORE MOLICA | ||||||||
| PHYSICIAN | 40.00 | $195,772 | $0 | $25,461 | Yes (X) | |||
| YI JUNG | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $194,213 | $0 | $25,048 | |||
| UNIQUE MICHAUD | ||||||||
| PHYSICIAN | 40.00 | $197,208 | $0 | $12,428 | Yes (X) | |||
| TARSHA WEAVER | ||||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $178,246 | $0 | $24,693 | |||
| PAMELA ADELSTEIN | ||||||||
| PHYSICIAN | 40.00 | $192,548 | $0 | $4,612 | Yes (X) | |||
| ANTHONY STANKIEWICZ | ||||||||
| CHIEF OF STAFF/ADVANCEMENT | 40.00 | Yes (X) | $182,315 | $0 | $1,448 | 1.00 | ||
| IVETTE ARIAS | ||||||||
| CHIEF HUMAN RESOURCES OFFICER | 40.00 | Yes (X) | $108,833 | $0 | $14,166 | |||
| ARDIS VAUGHAN | ||||||||
| PRESIDENT | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| STEPHEN WEYMOUTH ESQ | ||||||||
| PRESIDENT ELECT | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ROBERT J MACEACHERN | ||||||||
| VICE PRESIDENT | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARVA SEROTKIN | ||||||||
| TREASURER | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| THABITI BROWN | ||||||||
| CLERK | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CHARLES O'HARA | ||||||||
| BOARD MEMBER | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| JULIA CHARLEY | ||||||||
| BOARD MEMBER | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| EGOBUDIKE J EZEDI JR | ||||||||
| BOARD MEMBER | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| ISAAC COLBERT | ||||||||
| BOARD MEMBER | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| SANDRA WARREN | ||||||||
| BOARD MEMBER | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| EMMETT SCHMARSOW | ||||||||
| BOARD MEMBER | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| KATHERINE BOWES | ||||||||
| BOARD MEMBER | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| REV GARVIN WARDEN | ||||||||
| BOARD MEMBER | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| DESIREE OTENTI | ||||||||
| BOARD MEMBER | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,198,463 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $217,343 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 41 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CPA MEDICAL BILLING LLC | |||||
| 388 EAST MAIN STREET | BRANFORD | CT | 06405 | BILLING SERVICES | $1,186,337 |
| DOTHOUSE HEALTH INC | |||||
| 1452 DORCHESTER AVENUE | DORCHESTER | MA | 02122 | SHARED IT SERVICES | $706,122 |
| SHAWMUT DESIGN & CONSTRUCTION | |||||
| 560 HARRISON AVE | BOSTON | MA | 02118 | CONSTRUCTION CONTRACTOR | $504,686 |
| BU FAMILY MEDICINE ASSOCIATES DOWLING 5 | |||||
| ONE BOSTON MEDICAL CENTER PLACE | BOSTON | MA | 02118 | PHYSICIAN SERVICES | $455,948 |
| EVANS MEDICAL FOUNDATION INC | |||||
| 88 EAST NEWTON STREET | BOSTON | MA | 02118 | MEDICAL PROFESSIONAL SERVICES | $393,136 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $210,105 | FundraisingAmt |
| Government Grants | $3,652,759 | GovernmentGrantsAmt |
| All Other Contributions | $4,445,129 | AllOtherContributionsAmt |
| Noncash Contributions | $118,003 | NoncashContributionsAmt |
| Total Contributions | $8,307,993 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621400 | $31,438,959 | $31,438,959 |
| MEDICAL RECORD FEES | 621400 | $5,345 | $5,345 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $31,444,304 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $134,687 | TotalRevenueColumnAmt |
| Exclusion | $134,687 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $195,405 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $195,405 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $195,405 | TotalRevenueColumnAmt |
| Exclusion | $195,405 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $777,699 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $637,899 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $139,800 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $139,800 | TotalRevenueColumnAmt |
| Exclusion | $139,800 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $10,750 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $210,105 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $149,467 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$138,717 | TotalRevenueColumnAmt |
| Exclusion | -$138,717 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISC. REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $413,291 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $413,291 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $413,291 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,496,763 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,857,595 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $331,175 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,433,325 | TotalAmt |
| Program Services | $183,014 | ProgramServicesAmt |
| Management And General | $1,250,311 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,444,757 | TotalAmt |
| Program Services | $15,903,490 | ProgramServicesAmt |
| Management And General | $1,541,267 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,535 | TotalAmt |
| Program Services | $146,620 | ProgramServicesAmt |
| Management And General | $43,915 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,315,246 | TotalAmt |
| Program Services | $1,694,931 | ProgramServicesAmt |
| Management And General | $620,315 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,295,504 | TotalAmt |
| Program Services | $910,494 | ProgramServicesAmt |
| Management And General | $385,010 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,060 | TotalAmt |
| Program Services | $20,070 | ProgramServicesAmt |
| Management And General | $103,990 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,171 | TotalAmt |
| Program Services | $23,674 | ProgramServicesAmt |
| Management And General | $89,497 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,182 | TotalAmt |
| Fundraising | $43,182 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,687 | TotalAmt |
| Management And General | $45,687 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,076 | TotalAmt |
| Program Services | $430 | ProgramServicesAmt |
| Management And General | $11,646 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,527 | TotalAmt |
| Program Services | $24,919 | ProgramServicesAmt |
| Management And General | $31,608 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $558,751 | TotalAmt |
| Program Services | $296,828 | ProgramServicesAmt |
| Management And General | $261,923 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $944,589 | TotalAmt |
| Program Services | $5,164 | ProgramServicesAmt |
| Management And General | $939,425 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,899 | TotalAmt |
| Program Services | $6,487 | ProgramServicesAmt |
| Management And General | $2,412 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,769 | TotalAmt |
| Management And General | $30,769 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,413,280 | TotalAmt |
| Program Services | $357,438 | ProgramServicesAmt |
| Management And General | $1,055,842 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,592 | TotalAmt |
| Program Services | $59,502 | ProgramServicesAmt |
| Management And General | $113,090 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACTED SERVICES | $6,146,782 | $3,434,352 | $2,712,430 |
| PHARMACY | $5,785,247 | $5,785,247 | |
| MEDICAL SUPPLIES | $1,246,359 | $1,246,359 | |
| MISCELLANEOUS | $290,706 | $265,237 | $25,469 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $344,627 | TotalAmt |
| Program Services | $129,035 | ProgramServicesAmt |
| Management And General | $215,592 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,016,671 | TotalAmt |
| Program Services | $30,493,291 | ProgramServicesAmt |
| Management And General | $9,480,198 | ManagementAndGeneralAmt |
| Fundraising | $43,182 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,759 | BOYAmt |
| EOY | $1,759 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,735,266 | BOYAmt |
| EOY | $20,628,542 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $535,228 | BOYAmt |
| EOY | $1,248,754 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,637,233 | BOYAmt |
| EOY | $1,682,879 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $328,603 | BOYAmt |
| EOY | $149,687 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $262,400 | BOYAmt |
| EOY | $664,819 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $29,436,376 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,832,180 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,880,553 | BOYAmt |
| EOY | $17,604,196 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,526,311 | BOYAmt |
| EOY | $9,316,576 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,350,766 | BOYAmt |
| EOY | $757,939 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,258,119 | BOYAmt |
| EOY | $52,055,151 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,818,844 | BOYAmt |
| EOY | $5,636,930 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,359,920 | BOYAmt |
| EOY | $1,203,329 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,987,200 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $5,827,669 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,178,764 | BOYAmt |
| EOY | $16,655,128 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,281,250 | BOYAmt |
| EOY | $33,389,217 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,798,105 | BOYAmt |
| EOY | $2,010,806 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,079,355 | BOYAmt |
| EOY | $35,400,023 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,258,119 | BOYAmt |
| EOY | $52,055,151 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $480,092 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $559,460 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,281,116 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,055,117 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,105,806 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,908,089 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,323,827 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,318,743 | CurrentTaxYearAmt |
| Total | $33,711,582 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,055,117 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,105,806 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,908,089 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,323,827 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,318,743 | CurrentTaxYearAmt |
| Total | $33,711,582 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $787,849 | SubstantialContributorsTotAmt |
| Public Support Total170 | $32,923,733 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $285,774 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $294,744 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $489,576 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $459,500 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $330,092 | CurrentTaxYearAmt |
| Total | $1,859,686 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -$13,733 | CurrentTaxYearMinus4YearsAmt |
| Total | -$13,733 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $35,557,535 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $153,426,720 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.92590 | PublicSupportCY170Pct |
| Public Support PY170 | 0.90650 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER REVENUE - 2015 AMOUNT: $ -13,733. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,332,986 | OtherCostOrOtherBasisAmt |
| Book Value | $1,332,986 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,671,976 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,658,220 | DepreciationAmt |
| Book Value | $13,013,756 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $586,673 | OtherCostOrOtherBasisAmt |
| Depreciation | $97,569 | DepreciationAmt |
| Book Value | $489,104 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,844,741 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,076,391 | DepreciationAmt |
| Book Value | $2,768,350 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,604,196 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| REFUNDABLE ADVANCE | $5,700,000 |
| CONDITIONAL GRANT ADVANCE | $127,669 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,827,669 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $42,512,619 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $559,460 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $71,500 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $1,430,583 | OtherRevenueAmt |
| Revenue Not Reported | $2,061,543 | RevenueNotReportedAmt |
| Revenue Subtotal | $40,451,076 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $45,687 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $45,687 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $40,496,763 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $40,191,951 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $71,500 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $149,467 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $220,967 | ExpensesNotReportedAmt |
| Expenses Subtotal | $39,970,984 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $45,687 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $45,687 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $40,016,671 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HEALTH CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES IN ACCORDANCE WITH ASC TOPIC, INCOME TAXES. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE COMBINING FINANCIAL STATEMENTS REGARDING A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE HEALTH CENTER HAS DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS WHICH QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE COMBINING FINANCIAL STATEMENTS AT SEPTEMBER 30, 2020. THE HEALTH CENTER'S INFORMATION RETURNS ARE SUBJECT TO EXAMINATION BY THE FEDERAL AND STATE JURISDICTIONS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING DIRECT EXPENSE 149,467. FORGIVENESS OF DEBT 1,281,116. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING DIRECT EXPENSE 149,467. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
Organization Business Name OrganizationBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL P WASSERMAN INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 349 NEWBURY STREET SUITE 300 | AddressLine1Txt |
| City | BOSTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02115 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | EVENT PLANNER AND FUNDRAISER | ActivityTxt |
| Fundraiser Control Of Funds | Yes (1) | FundraiserControlOfFundsInd |
| Gross Receipts | $220,855 | GrossReceiptsAmt |
| Retained By Contractor | $43,182 | RetainedByContractorAmt |
| Net To Organization | $177,673 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $220,855 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $43,182 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $177,673 | TotalNetToOrganizationAmt |
| Licensed States | MA | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | MEN OF BOSTON COOK EVENT | Event1Nm |
| Gross Receipts Event1 | $220,855 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $210,105 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $10,750 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $57,845 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $17,990 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $2,950 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $70,682 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $220,855 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $210,105 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $10,750 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $57,845 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $17,990 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $2,950 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $70,682 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $149,467 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$138,717 | NetIncomeSummaryAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE G, PART I, LINE 2B, COLUMN (V) | FormAndLineReferenceDesc |
| Explanation | EVENT PLANNER AND FUNDRAISER | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SANDRA COTTERELL | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $280,971 | $0 | $0 | $0 | $0 | $0 | $23,619 | $0 | $21,851 | $0 | $326,441 | $0 | $0 | $0 |
| PHILIP SEVERIN | ||||||||||||||
| CHIEF MEDICAL OFFICER | $240,706 | $0 | $0 | $0 | $0 | $0 | $4,814 | $0 | $21,499 | $0 | $267,019 | $0 | $0 | $0 |
| STEPHENSON TOBIERRE | ||||||||||||||
| PHYSICIAN | $216,858 | $0 | $0 | $0 | $0 | $0 | $4,337 | $0 | $20,879 | $0 | $242,074 | $0 | $0 | $0 |
| STEPHEN TRINGALE | ||||||||||||||
| PHYSICIAN | $210,793 | $0 | $0 | $0 | $0 | $0 | $4,216 | $0 | $8,272 | $0 | $223,281 | $0 | $0 | $0 |
| SALVATORE MOLICA | ||||||||||||||
| PHYSICIAN | $195,772 | $0 | $0 | $0 | $0 | $0 | $3,915 | $0 | $21,546 | $0 | $221,233 | $0 | $0 | $0 |
| YI JUNG | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $194,213 | $0 | $0 | $0 | $0 | $0 | $3,884 | $0 | $21,164 | $0 | $219,261 | $0 | $0 | $0 |
| UNIQUE MICHAUD | ||||||||||||||
| PHYSICIAN | $197,208 | $0 | $0 | $0 | $0 | $0 | $3,944 | $0 | $8,484 | $0 | $209,636 | $0 | $0 | $0 |
| TARSHA WEAVER | ||||||||||||||
| CHIEF OPERATING OFFICER | $178,246 | $0 | $0 | $0 | $0 | $0 | $3,565 | $0 | $21,128 | $0 | $202,939 | $0 | $0 | $0 |
| PAMELA ADELSTEIN | ||||||||||||||
| PHYSICIAN | $192,548 | $0 | $0 | $0 | $0 | $0 | $3,851 | $0 | $761 | $0 | $197,160 | $0 | $0 | $0 |
| ANTHONY STANKIEWICZ | ||||||||||||||
| CHIEF OF STAFF/ADVANCEMENT | $182,315 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,448 | $0 | $183,763 | $0 | $0 | $0 |
| IVETTE ARIAS | ||||||||||||||
| CHIEF HUMAN RESOURCES OFFICER | $108,833 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,166 | $0 | $122,999 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | PERSONAL PROTECTIVE EQUIPMENT | Desc |
| Contribution | 0 | ContributionCnt |
| Noncash Contributions Rpt F990 | $118,003 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | TWO OF THE DIRECTORS ARE SIBLINGS: KATHERINE BOWES AND EMMETT SCHMARSOW. |
| FORM 990, PART VI, SECTION A, LINE 7A | EXPLANATION: THE BOARD MEMBERS HAVE THE POWER TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS AND MEMBERS OF THE BOARD MUST COMPLETE ANNUAL SIGN OFFS ON THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF THE CEO IS DETERMINED AND EVALUATED BY THE BOARD OF DIRECTORS. THE BOARD ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW AND MAKE RECOMMENDATIONS REGARDING COMPENSATION AND BENEFITS FOR ALL POSITIONS. COMPENSATION OF OTHER OFFICERS AND KEY STAFF MEMBERS IS DETERMINED BY HUMAN RESOURCES, IN CONJUNCTION WITH THE CEO AND EXECUTIVE TEAM. THE MASSACHUSETTS LEAGUE OF COMMUNITY HEALTH CENTER'S ANNUAL SALARY AND COMPENSATION SURVEY IS USED DURING SUCH REVIEWS. |
| FORM 990, PART VI, SECTION C, LINE 19 | CODMAN SQUARE HEALTH CENTER MAKES THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | FORGIVENESS OF CONTINGENT NOTE PAYABLE 1,281,116. |
| FORM 990, PART XII, LINE 2C: | THERE HAS BEEN NO CHANGE FROM PRIOR YEARS. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CODMAN EYE CARE AFFILIATES - SOUTH SHORE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 637 WASHINGTON STREET | AddressLine1Txt |
| City | DORCHESTER | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02124 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 825132976 | EIN |
| Primary Activities | EYE CARE | PrimaryActivitiesTxt |
| Legal Domicile State | MA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CODMAN SQUARE HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $400,232 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $522,200 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CODMAN EYE CARE AFFILIATES - SOUTH SHORE INC | ||
| D | $342,663 | AMOUNT DUE FROM CECA |
| CODMAN EYE CARE AFFILIATES - SOUTH SHORE INC | ||
| B | $415,276 | BOOK VALUE |
Comments