2020-02-13T14:38:32-06:00 2019-03-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2018-04-01 200547132 MONMOUTH FAMILY HEALTH CENTER MONM 7329630159 270 BROADWAY LONG BRANCH NJ 07740 ROBERT J AURIEMMA CFO 7329630159 2020-02-11 1 KERRI N BOGDA CPA P00760402 7177404863 96.89.178.154 2020-02-11 16:05:44 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AE0C272A69DD34E2EDF3B6A185DE1CF90EACE8A4 2018 2020-09-23 17:36:50Z ROBERT J AURIEMMA 270 BROADWAY LONG BRANCH NJ 07740 9620853 0 X WWW.MFHCNJ.ORG X 2004 NJ PROVIDE A BROAD RANGE OF HEALTH SERVICES TO THE MEDICALLY UNDERSERVED POPULATION IN MONMOUTH COUNTY. 11 11 109 11 0 0 2645020 2690304 7241943 6901518 18640 21507 6611 7524 9912214 9620853 0 0 0 0 5133344 5194381 0 0 0 4954931 4659541 10088275 9853922 -176061 -233069 8085173 7858755 1213315 1219517 6871858 6639238 X TO PROVIDE MEDICAL, DENTAL, AND OTHER SOCIAL SERVICES TO THE UNDERSERVED POPULATION OF MONMOUTH COUNTY, NEW JERSEY. 0 0 7863741 0 6901518 FOR THE FISCAL YEAR ENDED 3/31/2019, THE CENTER PROVIDED OUTPATIENT HEALTHCARE SERVICES TO APPROXIMATELY 14,000 PATIENTS, TOTALING APPROXIMATELY 50,000 VISITS. SERVICES INCLUDED OBSTETRICS / GYNECOLOGY, MEDICINE, PEDIATRICS, BEHAVIORAL HEALTH SERVICES, DENTAL, PODIATRY AND HIV. THE CENTER CONTINUES TO PROVIDE COMMUNITY IN-REACH, OUTREACH AND ENROLLMENT ASSISTANCE IN ORDER TO MEET ANTICIPATED INCREASES IN PATIENT AND SERVICE AREA NEEDS.THE CENTER IS OPEN TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE CENTER PROVIDES CHARITY CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER A SLIDING FEE DISCOUNT POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. COMMUNITY BENEFIT REPRESENTS THE COST OF SERVICES FOR MEDICAID, MEDICARE, AND OTHER PUBLIC PATIENTS FOR WHICH THE CENTER IS NOT REIMBURSED. CHARITY CARE AND COMMUNITY BENEFIT PROVIDED TO PATIENTS DURING THE FISCAL YEAR ENDED 3/31/2019 APPROXIMATED $1,172,000 AND $1,432,000, RESPECTIVELY. 7863741 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 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 39 0 109 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 1 1 1 1 0 NJ X ROBERT J AURIEMMA CFO 7329630159 80 PAVILION AVE LONG BRANCH NJ 07740 KATHLEEN BILLINGS CHAIRPERSON 1.00 X X 0 0 0 DEBRA BRADLEY VICE CHAIRPERSON 1.00 X X 0 0 0 WEBSTER TRAMMELL PSY D SECRETARY 1.00 X X 0 0 0 ERIC CARNEY TREASURER 1.00 X X 0 0 0 RODNEY O'NEAL TREASURER (UNTIL 07/2018) 1.00 X X 0 0 0 DIANA TENNANT TRUSTEE 1.00 X 0 0 0 MARJORIE BAFATY TRUSTEE 1.00 X 0 0 0 JOYCE QUARLES TRUSTEE 1.00 X 0 0 0 JOAN WILLS TRUSTEE 1.00 X 0 0 0 JEFFREY LEDERMAN MD TRUSTEE 1.00 X 0 0 0 CARL JENNINGS TRUSTEE 1.00 X 0 0 0 ANDRES MEJER TRUSTEE 1.00 X 0 0 0 MARTA C SILVERBERG EXECUTIVE DIRECTOR 40.00 X 192317 0 28626 ROBERT J AURIEMMA CHIEF FINANCIAL OFFICER 40.00 X 120982 0 27884 RAKSHA JOSHI MD CHIEF MEDICAL OFFICER 40.00 X 291128 0 31259 DR MARIELA KAPOOR PHYSICIAN 36.00 X 216646 0 38288 AAREFA SHAKIR MD PHYSICIAN 24.00 X 143334 0 4480 TITHI MITRA MD PHYSICIAN 24.00 X 112439 0 3373 1076846 0 133910 6 0 1 0 MONMOUTH MEDICAL CENTER 300 2ND AVENUE LONG BRANCH NJ 07740 RESIDENT SERVICES 984649 STERICYCLE INC 4010 COMMERCIAL AVENUE NORTHBROOK IL 60062 MEDICAL WASTE REMOVAL SERVICES 117862 2 1768995 921309 518309 2690304 MEDICAID 621990 3761253 3761253 NJ UNCOMPENSATED 621990 1379088 1379088 SELF PAY 621990 911620 911620 340B PROGRAM 621990 565715 565715 MEDICARE 621990 283842 283842 6901518 21507 21507 MEDICAL RECORDS 900099 7410 7410 114 114 7524 9620853 6901518 0 29031 X 685660 480665 204995 3456916 2592687 864229 106039 74336 31703 546859 414830 132029 398907 279644 119263 7370 4386 2984 55347 32941 22406 1759160 1488828 270332 160967 132286 28681 516712 385777 130935 12077 9220 2857 8213 6270 1943 531642 425314 106328 70944 58303 12641 PHARMACY SUPPLIES 753725 753725 REPAIRS & MAINTENANCE 184756 151837 32919 DENTAL SUPPLIES 154133 154133 BAD DEBT EXPENSE 150000 150000 294495 268559 25936 9853922 7863741 1990181 0 379793 91405 2016494 2267564 2571136 2803218 123277 128810 5691368 3779665 2358052 1911703 592321 611955 44100 44100 8085173 7858755 1113065 1127704 100250 91813 1213315 1219517 X 6871858 6639238 6871858 6639238 8085173 7858755 -233069 449 0 X 0 1 X 1 1 1 X 3701479 2276298 2454527 2645020 2690304 13767628 3701479 2276298 2454527 2645020 2690304 13767628 3840134 9927494 10730 6491 14175 18640 21507 71543 10132 7555 6611 7524 31822 13870993 34751502 0.71570 0.73980 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2015 AMOUNT: $ 4,038. 2016 AMOUNT: $ 6. 2017 AMOUNT: $ 250. 2018 AMOUNT: $ 114. MEDICAL RECORDS - 2015 AMOUNT: $ 6,094. 2016 AMOUNT: $ 7,549. 2017 AMOUNT: $ 6,361. 2018 AMOUNT: $ 7,410. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 101654 47204 54450 3970999 2306389 1664610 1618715 1426072 192643 1911703 X 9471302 449 -150000 -149551 9620853 0 9620853 9703922 0 9703922 150000 150000 9853922 PART X, LINE 2: THE CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OR MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD FOR 2019 AND 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIALS -150,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIALS 150,000. X X 0 0 0 0 0 0 0 0 0 MARTA C SILVERBERG EXECUTIVE DIRECTOR 192317 0 0 0 0 0 5884 0 22742 0 220943 0 0 0 RAKSHA JOSHI MD CHIEF MEDICAL OFFICER 291128 0 0 0 0 0 8297 0 22962 0 322387 0 0 0 DR MARIELA KAPOOR PHYSICIAN 216646 0 0 0 0 0 6712 0 31576 0 254934 0 0 0 X 1 518309 CURRENT SALES PRICE 0 1 0 PART I, COLUMN (B): NUMBER OF CONTRIBUTIONS IN PART I, COLUMN B REPRESENTS THE TOTAL NUMBER OF CONTRIBUTORS FOR THAT PARTICULAR ITEM. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION PROVIDES THE BOARD OF TRUSTEES WITH AN ELECTRONIC COPY OF THE FORM 990 IN ADVANCE OF FILING WITH THE IRS. PRIOR TO FILING, THE TAX PREPARER IS AVAILABLE TO ANSWER ALL QUESTIONS THAT ANY MEMBER OF THE BOARD OF TRUSTEES MAY HAVE. FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, THROUGH BUSINESS, INVESTMENT, OR FAMILY IN AN ENTITY OR INDIVIDUAL WITH WHICH THE CORPORATION HAS A TRANSACTION OR ARRANGEMENT MUST COMPLETE A CONFLICT OF INTEREST STATEMENT. IN ADDITION, IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS. DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS MONITOR THE CONFLICT OF INTEREST POLICY ON A REGULAR BASIS. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE INTERESTED PERSON MAY NOT PARTICIPATE IN THE DISCUSSION OF, OR VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTED IN THE CONFLICT OF INTEREST. MANAGEMENT WILL DETERMINE IF THE CONFLICT IS OF A NATURE THAT MUST BE REFERRED TO LEGAL COUNSEL FOR RECOMMENDATION AS TO THE APPROPRIATE ACTION TO BE TAKEN. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO IS DETERMINED VIA INDEPENDENT COMPENSATION SURVEYS, INCLUDING THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE NEW JERSEY PRIMARY CARE ASSOCIATION, TO ENSURE THAT TOTAL ANNUAL COMPENSATION IS COMPARABLE AND DOES NOT EXCEED THE FAIR MARKET VALUE OF CEO POSITIONS IN SIMILAR FEDERALLY QUALIFIED HEALTH CENTERS (FQHC'S) WITHIN THE STATE. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD. ADDITIONALLY, THE PROCESS FOR DETERMINING THE CEO'S COMPENSATION IS DOCUMENTED IN THE BOARD MEETING MINUTES. THE PROCESS FOR DETERMINING OTHER EMPLOYEE COMPENSATION IS NOT DOCUMENTED IN THE BOARD MEETING MINUTES. THE COMPENSATION OF THE CFO AND CMO IS DETERMINED VIA INDEPENDENT COMPENSATION SURVEYS, INCLUDING THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE NEW JERSEY PRIMARY CARE ASSOCIATION, TO ENSURE THAT TOTAL ANNUAL COMPENSATION IS COMPARABLE AND DOES NOT EXCEED THE FAIR MARKET VALUE OF THESE POSITIONS IN SIMILAR FQHC'S WITHIN THE STATE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE ALL GOVERNING DOCUMENTS TO ANY PERSON(S) WHO REQUEST THE DOCUMENTS EITHER IN WRITING OR IN PERSON. UPON THE REQUEST, THE ORGANIZATION LOGS WHAT WAS REQUESTED, BY WHOM, AND WHERE AND WHEN THE DOCUMENTS WERE SENT. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 936,649. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 936,649. DENTIST FEES: PROGRAM SERVICE EXPENSES 62,865. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,865. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 164,267. MANAGEMENT AND GENERAL EXPENSES 111,730. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 275,997. MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 71,952. MANAGEMENT AND GENERAL EXPENSES 48,939. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 120,891. LABORATORY FEES: PROGRAM SERVICE EXPENSES 91,866. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,866. DATA PROCESSING: PROGRAM SERVICE EXPENSES 161,229. MANAGEMENT AND GENERAL EXPENSES 109,663. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 270,892.