2021-10-07T12:11:52-05:00 2020-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2020-01-01 133083068 COMMUNITY HEALTHCARE NETWORK COMM 2125452404 60 MADISON AVENUE NEW YORK NY 10010 ALAN WENGROFSKY CFO AND VP OF FINANCE 2125452404 2021-11-15 1 ALAN WENGROFSKY 999009999 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2021-10-04 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z ROBERT HAYES 60 MADISON AVENUE NEW YORK NY 10010 137571293 0 X WWW.CHNNYC.ORG X 1978 NY COMMUNITY HEALTHCARE NETWORK, INC ("CHN") OPERATES FREESTANDING DIAGNOSTIC AND TREATMENT CENTERS, DESIGNATED AS A FEDERALLY QUALIFIED HEALTH CENTER, LICENSED UNDER ARTICLE 28 AND ARTICLE 31 OF THE NEW YORK STATE HEALTH LAW, LOCATED THOUGHOUT NEW YORK CITY. CHN PROVIDES A BROAD RANGE OF HEALTH SERVICES INCLUDING BUT NOT LIMITED TO PRIMARY AND PREVENTATIVE CARE, AND MENTAL HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION. 16 16 748 0 243665 44508 27274281 34422232 62000820 72902494 647946 1995064 625618 675605 90548665 109995395 0 0 0 0 58088664 54118782 0 0 122 39038809 50863037 97127473 104981819 -6578808 5013576 96032281 116375376 22897266 35534201 73135015 80841175 CHN PROVIDES A BROAD RANGE OF HEALTH SERVICES INCLUDING BUT NOT LIMITED TO PRIMARY AND PREVENTATIVE CARE, AND MENTAL HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION. 0 0 93756826 73578099 CHN PROVIDES A BROAD RANGE OF HEALTH SERVICES INCLUDING BUT NOT LIMITED TO PRIMARY AND PREVENTATIVE CARE, AND MENTAL HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION. CHN PROVIDED HEALTH CARE SERVICES FOR 185,268 HEALTH CARE VISITS FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2020. 93756826 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 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 1 1 0 0 0 1 83 0 1 748 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X ALAN WENGROFSKY 2125452481 60 MADISON AVE NEW YORK NY 10010 BRENDA MERRITT BOARD MEMBER 1.00 X 0 0 0 CAROLINE DORSEN BOARD MEMBER 1.00 X 0 0 0 DENISE GORDON BOARD MEMBER 1.00 X 0 0 0 DONNA ANDERSON BOARD MEMBER 1.00 X 0 0 0 ELIZABETH KELLNER CHAIRPERSON 1.00 0.50 X X 0 0 0 GRETA ELYSEE BOARD MEMBER 1.00 X 0 0 0 HARLEM J GUNNESS BOARD MEMBER 1.00 X 0 0 0 JEFFREY ROBINSON BOARD MEMBER 1.00 X 0 0 0 JOSEPHINE DIAZ BOARD MEMBER 1.00 X 0 0 0 JUNE NIKLUS VICE CHAIRPERSON 1.00 X X 0 0 0 KATHLEEN O'NEIL BOARD MEMBER 1.00 X 0 0 0 KRISTIN MANZOLILLO SECRETARY 1.00 X X 0 0 0 NANCY RAPOPORT TREASURER 1.00 X X 0 0 0 RALPH AQUILA BOARD MEMBER 1.00 X 0 0 0 RANDY SILLER BOARD MEMBER 1.00 X 0 0 0 RONDA KOTELCHUCK BOARD MEMBER 1.00 X 0 0 0 ALAN WENGROFSKY CFO/VP FINANCE 35.00 X 323819 0 49989 ROBERT HAYES PRESIDENT/CEO 34.50 0.50 X 456591 0 47575 DAVID GROSS LEGAL COUNSEL 35.00 X 238537 0 42899 GREGORY TADDEO CHIEF DENTAL OFFICER 35.00 X 225772 0 24243 KENNETH MEYER VP HUMAN RESOURCES 35.00 X 202680 0 42013 JOSEPH SQUITIERI DIRECTOR OF PSYCHIATRY 35.00 X 245406 0 40883 KRISTEN MANTER CHIEF OF PRIMARY CARE 35.00 X 255042 0 41502 SATOKO KANAHARA MEDICAL DIRECTOR 35.00 X 226693 0 23634 SHARON GRIFFITH MEDICAL DIRECTOR/WOMEN SERVICES 35.00 X 241842 0 46406 TAISHA BENJAMIN DIRECTOR OF PEDIATRICS 35.00 X 237902 0 39556 2654284 0 398700 96 0 1 0 RELEVANT HEALTHCARE TECHNOLOGIES 222 BROADWAY 19TH FLOOR NEW YORK NY 10038 HEALTH HOME BILLING SERVICES 478219 COHNREZNICK LLP 1301 AVE OF THE AMERICAS NEW YORK NY 10019 ACCOUNTING & TAX 460702 FIDELUS TECHNOLOGIES LLC 11 PARK PLACE NEW YORK NY 10007 TECHNOLOGY 211080 SCRIBE AMERICA PO BOX 417756 BOSTON MA 02241 HEALTHCARE STAFFING 138447 ALL MEDICAL PERSONNEL 4000 HOLLYWOOD BLVD HOLLYWOOD FL 33021 HEALTHCARE STAFFING 121223 6 28137956 6284276 566381 34422232 HEALTH HOME REVENUE 623000 32373991 32373991 MEDICAID & MEDICAID MANAGED CARE 623000 22782873 22782873 340B PHARMACY 623000 10773339 10529674 243665 NEW YORK STATE UNCOMPENSATED CARE 623000 3156679 3156679 PRIVATE INSURANCE 623000 2888078 2888078 927534 927534 72902494 820478 820478 28750484 27575898 1174586 1174586 1174586 PATIENT INCENTIVES INCOME 900099 392971 392971 MISCELLANEOUS INCOME 900099 252624 252624 CCMP 900099 30010 30010 675605 109995395 73334434 243665 1995064 1654118 1436015 218103 40177435 34879874 5297561 367711 319227 48484 8298536 7204340 1094196 3620982 3143540 477442 59414 59414 446200 446200 55250 55250 231448 231448 1774728 1475321 299407 20483 20483 1971427 1505003 466424 3826924 2908462 918462 82550 71819 10731 285681 248542 37139 1325499 1007378 318121 285335 216855 68480 HEALTH HOME FEES 25747317 25747317 CONSUMABLE SUPPLIES 11161857 11040032 121825 REPAIRS AND MAINTENANCE 616503 468542 147961 EQUIPMENT RENTAL 420335 319455 100880 2552086 1689371 862593 122 104981819 93756826 11224871 122 2730518 8009749 23640066 27500991 7300509 10013431 8469380 9917443 157079 151204 834567 1119270 44145666 29576904 10819271 14568762 32046132 27287701 1109649 1139659 8925110 16667166 96032281 116375376 10529607 15137272 1795085 672984 9341001 18702785 1231573 1021160 22897266 35534201 X 70332900 77485271 2802115 3355904 73135015 80841175 96032281 116375376 5013576 2692584 0 X X 0 1 X 1 1 1 X 20404682 24373719 25373481 27313131 34422232 131887245 20404682 24373719 25373481 27313131 34422232 131887245 131887245 630463 1050982 97296 684178 820478 3283397 475729 243665 719394 1148109 2104859 1365847 725516 675605 6019936 141909972 325101937 0.92940 0.92000 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: CCMP REVENUE - 2016 AMOUNT: $ 564,315. 2017 AMOUNT: $ 160,557. 2018 AMOUNT: $ 223,745. 2019 AMOUNT: $ 40,964. 2020 AMOUNT: $ 30,010. FUNDRAISING REVENUE - 2016 AMOUNT: $ 14,200. 2017 AMOUNT: $ 30,360. 2018 AMOUNT: $ 32,375. 2019 AMOUNT: $ 38,850. MEANINGFUL USE - 2017 AMOUNT: $ 663,000. MISCELLANEOUS INCOME - 2017 AMOUNT: $ 232,275. 2018 AMOUNT: $ 531,163. 2019 AMOUNT: $ 645,702. 2020 AMOUNT: $ 252,624. OTHER PATIENT REVENUE - 2016 AMOUNT: $ 498,566. 2017 AMOUNT: $ 437,770. 2018 AMOUNT: $ 532,029. 2020 AMOUNT: $ 301,773. QARR HIV REVENUE - 2016 AMOUNT: $ 25,355. 2017 AMOUNT: $ 580,897. 2020 AMOUNT: $ 91,198. QCCP REVENUE - 2016 AMOUNT: $ 45,673. 2018 AMOUNT: $ 46,535. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 55250 0 0 55250 0 PART II-B, LINE 1: THE LOBBYING ACTIVITIES INCLUDE RETENTION OF CONSULTANTS TO ADVISE CHN ON POLICY INITIATIVES AND ON OPPORTUNITIES TO SECURE SUPPORT FOR NEEDED COMMUNITY HEALTHCARE SERVICES INCLUDING A MOBILE OPTOMETRY CENTER AND ADDITIONAL CLINIC SPACE. 37931 37931 14809215 10959563 3849652 8218436 7633952 584484 10120859 9103482 1017377 10959225 1879907 9079318 14568762 SECURITY DEPOSITS 994166 SUBVENTION RECEIVABLE 1000000 DUE FROM AFFILIATE 14673000 16667166 DEFERRED RENT 762823 DUE TO THIRD PARTY 258337 1021160 X 112531809 2692584 75278 2767862 109763947 231448 231448 109995395 104750581 210 210 104750371 231448 231448 104981819 PART X, LINE 2: THE ORGANIZATION HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2020. CHN'S FEDERAL AND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2017 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS OPERATING EXPENSES AND INCLUDES ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE CONSOLIDATED STATEMENT OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION REVENUE 75,278. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION EXPENSES 210. X 0 0 0 0 0 0 0 1 0 ROBERT HAYES PRESIDENT/CEO 455008 0 0 0 1583 0 14250 0 33325 0 504166 0 0 0 ALAN WENGROFSKY CFO/VP FINANCE 323532 0 0 0 287 0 14250 0 35739 0 373808 0 0 0 KRISTEN MANTER CHIEF OF PRIMARY CARE 254857 0 0 0 185 0 12835 0 28667 0 296544 0 0 0 SHARON GRIFFITH MEDICAL DIRECTOR/WOMEN SERVICES 241306 0 0 0 536 0 12331 0 34075 0 288248 0 0 0 JOSEPH SQUITIERI DIRECTOR OF PSYCHIATRY 245282 0 0 0 124 0 12350 0 28533 0 286289 0 0 0 DAVID GROSS LEGAL COUNSEL 238412 0 0 0 125 0 12119 0 30780 0 281436 0 0 0 TAISHA BENJAMIN DIRECTOR OF PEDIATRICS 237777 0 0 0 125 0 11929 0 27627 0 277458 0 0 0 SATOKO KANAHARA MEDICAL DIRECTOR 226581 0 0 0 112 0 11437 0 12197 0 250327 0 0 0 GREGORY TADDEO CHIEF DENTAL OFFICER 225587 0 0 0 185 0 11384 0 12859 0 250015 0 0 0 KENNETH MEYER VP HUMAN RESOURCES 201858 0 0 0 822 0 10336 0 31677 0 244693 0 0 0 PART I, LINE 7 INCLUDED ON PART II, COLUMN B(II) ARE AMOUNTS REPRESENTING BONUS PAYMENTS. THESE AMOUNTS WERE APPROVED BY THE BOARD AND INCLUDED IN THE INDIVIDUAL'S 2020 W-2'S. X 4 566381 FMV 0 0 0 PART I, COLUMN (B): COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY INDEPENDENT ACCOUNTANT AND REVIEWED BY MANAGEMENT. IT IS THEN REVIEWED BY THE CHAIR OF THE BOARD AND THE FINANCE COMMITTEE AND DISTRIBUTED TO THE ENTIRE BOARD OF DIRECTORS BEFORE FILLING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL MANAGEMENT AND EMPLOYEES WHO ARE IN A POSITION TO INFLUENCE ANY SUBSTANTIVE BUSINESS DECISIONS SHALL, AT LEAST ANNUALLY, FILE A CONFLICT OF INTEREST DISCLOSURE STATEMENTS AND CONSULT WITH OUTSIDE COUNSEL, AS NECESSARY, CONCERNING ANY POTENTIAL PROBLEMS OR POSSIBLE CONFLICTS OF INTEREST. IN ADDITION, TO COMPLETING THE ANNUAL DISCLOSURE STATEMENT, ALL EMPLOYEES MUST ALSO IMMEDIATELY DISCLOSE TO THE COMPLIANCE OFFICER ANY POSSIBLE CONFLICTS OF INTEREST AS THEY ARISE. THE COMPLIANCE OFFICER, AS NECESSARY, WILL THEN CONSULT WITH OUTSIDE COUNSEL. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS DETERMINES AND APPROVES COMPENSATION OF THE CEO BASED ON RECOMENDATIONS FROM EXECUTIVE COMMITEE. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE SELECTION AND OVERSIGHT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 990, PART IV, LINE 20A: THE ORGANIZATION IS LICENSED UNDER ARTICLE 28 OF NEW YORK STATE PUBLIC HEALTH LAW. HOWEVER, SUBSECTION 10 OF ARTICLE 28 EXCLUDES CERTAIN HEALTHCARE FACILITIES FROM THE DEFINITION OF GENERAL HOSPITAL. THEREFORE, THE ORGANIZATION IS NOT INCLUDING SCHEDULE H IN THE CURRENT YEAR FORM 990 AS THEY DO NOT MEET THIS DEFINITION. COMMUNITY HEALTHCARE NETWORK FOUNDATION INC 60 MADISON AVENUE NEW YORK NY 10010 843909175 SUPPORT COMMUNITY HEALTHCARE NETWORK, INC. NY 501(C)(3) LINE 12A, I COMMUNITY HEALTHCARE NETWORK INC 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0