2020-11-13T08:57:16-06:00 2019-12-31 814629899 BSC GROUP LLC 28614 MARLBORO AVE SUITE 103 EASTON MD 21601 990 2019-01-01 521116591 CHOPTANK COMMUNITY HEALTH SYSTEM INC CHOP 4104794306 PO BOX 660 DENTON MD 21629 SARA RICH CEO 4104794306 2020-11-04 1 CARVILLE B LEAF P00040844 4108226950 138.207.175.195 2020-11-04 13:19:59 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D1012FFE9F02818D612CB2AF3C0B773D73C14674 2019 2021-01-29 14:40:06Z SARA RICH PO BOX 660 DENTON MD 21629 24165000 0 X CHOPTANKHEALTH.ORG X 1978 MD PRIMARY HEALTH CARE SERVICES, DELIVERY OF HEALTH CARE TO MEDICALLY UNDERSERVED COMMUNITY 10 10 241 10 0 0 5332456 7270034 12306381 14189955 147890 764208 1983958 1792646 19770685 24016843 0 0 0 0 13830632 15371039 0 0 0 4444507 5227974 18275139 20599013 1495546 3417830 16367964 24888155 2520886 7576022 13847078 17312133 PRIMARY HEALTH CARE SERVICES: DELIVERY OF HEALTH CARE TO MEDICALLY UNDERSERVED COMMUNITY 0 0 16560024 16746809 PRIMARY HEALTH CARE SERVICES: DELIVERY OF HEALTHCARE TO MEDICALLY UNDERSERVED COMMUNITY 16560024 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 44 0 1 241 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 0 1 1 1 1 1 1 1 0 X KIMBERLY R LOVE FINANCE DIRECTOR 4104794306 301 RANDOLPH ST DENTON MD 21629 JOHN MASONE DIRECTOR 1.00 X X 0 0 0 SANDRA O'NEILL DIRECTOR 1.00 X 0 0 0 REBECCA LOUKIDES VICE CHAIR 1.00 X 0 0 0 CRYSTAL DADDS DIRECTOR 1.00 X 0 0 0 COREY PACK DIRECTOR 1.00 X 0 0 0 MICHAEL CAMPBELL DIRECTOR 1.00 X 0 0 0 LORENZO HUGHES DIRECTOR 1.00 X 0 0 0 PAULINE PINKETT DIRECTOR 1.00 X 0 0 0 MATTHEW PETERS TREASURER 1.00 X 0 0 0 JENNIFER YOST DIRECTOR 1.00 X 0 0 0 SARA VISINTAINER CHAIRMAN 1.00 X 0 0 0 SARA RICH CHIEF EXECUTIVE OFFICER 40.00 X 165244 0 17086 BEN COTTLE CHIEF FINANCIAL OFFICER 40.00 X 135063 0 7440 MARK FABER MD PHYSICIAN 40.00 X 191278 0 12426 CHRISTINA DORSTIN PHYSICIAN 40.00 X 172395 0 11484 KATELIN HALEY PHYSICIAN 40.00 X 194797 0 10664 SANDRA GARBELY-KERKOVICH DMD PHYSICIAN 40.00 X 183622 0 13006 USMAN ALI PHYSICIAN 40.00 X 187187 0 6659 1229586 0 78765 7 0 1 0 GILLIS GILKERSON 150 WEST MARKET STREET SUITE 200 SALISBURY MD 21801 CONSTRUCTION CONTRACTOR 4624584 HEALTH CHOICE NETWORK INC 9064 NW 13TH TERRACE DORAL FL 33172 HEALTH TECHNOLOGY SOLUTIONS 639282 BENCO DENTAL PO BOX 731372 DALLAS TX 75373 DENTAL SUPPLIES 570942 HENRY SCHEIN PO BOX 382023 PITTSBURGH PA 15250 MEDICAL SUPPLIES 569634 VOLOGY PO BOX 116354 ATLANTA GA 303686354 IT SERVICES 192748 5 6294055 975979 7270034 MEDICAL SERVICES 621400 14189955 14189955 14189955 162365 162365 1771104 1771104 750000 148157 601843 601843 601843 MISCELLANEOUS 900099 21542 21542 21542 24016843 16746809 0 0 12679030 10246211 2432819 227978 184234 43744 1535939 1241227 294712 928092 750012 178080 45667 45667 24687 24687 69180 69180 499654 399969 99685 84825 68708 16117 10717 10717 456000 369360 86640 68455 37785 30670 PROFESSIONAL FEES 1640929 1232847 408082 SUPPLIES 1169397 1115610 53787 BAD DEBTS 420445 420445 TELEPHONE 125874 62937 62937 612144 315832 296312 20599013 16560024 4038989 0 6744333 9592461 1461803 1224910 364226 382829 96612 551215 21611240 8490600 7660890 13120640 100 100 40000 16000 16367964 24888155 1653920 2009484 237900 283490 5111215 629066 171833 2520886 7576022 X 13847078 17312133 13847078 17312133 16367964 24888155 3417830 59013 -11788 0 X 0 1 X 0 1 1 X 4541975 5266085 5291692 5332456 7270034 27702242 4541975 5266085 5291692 5332456 7270034 27702242 27702242 82065 97108 127334 147890 1933469 2387866 69848 51463 137800 66664 623385 949160 31039268 58389355 0.89250 0.96450 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 603175 603175 15843393 4075488 11767905 5164672 4415112 749560 13120640 PATIENT OVERPAYMENTS 171833 171833 X 23760415 59013 105004 164017 23596398 420445 420445 24016843 20283572 105004 105004 20178568 420445 420445 20599013 PART X, LINE 2: THE ORGANIZATION BELIEVES IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 420,445. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 420,445. X X 0 0 0 0 0 0 0 0 0 SARA RICH CHIEF EXECUTIVE OFFICER 165244 0 0 0 0 0 5311 0 11775 0 182330 0 0 0 MARK FABER MD PHYSICIAN 172892 0 18386 0 0 0 5933 0 6493 0 203704 0 0 0 CHRISTINA DORSTIN PHYSICIAN 156518 0 15877 0 0 0 5356 0 6128 0 183879 0 0 0 KATELIN HALEY PHYSICIAN 175736 0 19061 0 0 0 5984 0 4680 0 205461 0 0 0 SANDRA GARBELY-KERKOVICH DMD PHYSICIAN 160729 0 22893 0 0 0 5727 0 7279 0 196628 0 0 0 USMAN ALI PHYSICIAN 187187 0 0 0 0 0 0 0 6659 0 193846 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 PREPARED BY AN OUTSIDE INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY THE ORGANIZATION'S FINANCIAL MANAGER AND CHIEF FINANCIAL OFFICER. THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION REVIEWS THE RETURN BEFORE SIGNING. FORM 990, PART VI, SECTION B, LINE 12C 1. EACH EMPLOYEE IS REQUIRED TO READ THE CONFLICT OF INTEREST POLICY IN THE EMPLOYEE HANDBOOK AND TO SIGN A STATMENT AS TO HAVING HAD REVIEWED AND UNDERSTOOD THE CONFLICT OF INTEREST POLICY. 2. CONFLICTS OF INTEREST OR THE APPEARANCE THEREOF ARE REVIEWED ON AN INDIVIDUAL BASIS AS POSSIBLE OR POTENTIAL CONFLICTS BECOME KNOWN. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AS A PART OF THE DEVELOPMENT OF THE CEO'S EMPLOYMENT CONTRACT. IN ESTABLISHING THE CEO'S COMPENSATION, THE EXECUTIVE COMMITTEE CONSIDERS THE INDIVIDUAL'S PERFORMANCE, ORGANIZATION'S PERFORMANCE, GENERAL MARKET CONDITIONS AND COMPENSATION PAID FOR COMPARABLE POSITIONS IN SIMILAR ORGANIZATIONS. THE DECISIONS OF THE EXECUTIVE COMMITTEE ARE DOCUMENTED IN THE MINUTES OF THE EXECUTIVE COMMITTEE WHICH ARE REVIEWED BY THE BOARD OF DIRECTORS. THE DECISIONS ARE REFLECTED IN THE CEO'S EMPLOYMENT CONTRACT WHICH IS APPROVED BY THE BOARD OF DIRECTORS. ALL OTHER COMPENSATION DECISIONS HAVE BEEN DELEGATED TO THE CEO BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC.