2019-11-15T13:09:43-06:00 2018-12-31 341900735 CBIZ MHM OF FLORIDA LLC 2255 GLADES ROAD SUITE 321A BOCA RATON FL 33431 990 2018-01-01 237211732 UPHAMS CORNER HEALTH COMMITTEE INC UPHA 6172878000 500 COLUMBIA ROAD DORCHESTER MA 02125 JAGDEEP TRIVEDI CHIEF EXECUTIVE OFFICER 6172878000 2019-11-13 1 DAVID A KATZMAN P00033289 5619945050 23.31.34.73 2019-11-13 15:09:45 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 265FCF31C30C0DF67A265E9800A4B322E1ECF162 2018 2020-04-17 16:48:07Z JAGDEEP TRIVEDI 500 COLUMBIA ROAD DORCHESTER MA 02125 43269188 0 X INFO@UPHAMS.ORG X 1971 MA COMPREHENSIVE COMMUNITY CARE THAT INCLUDES PRIMARY & SPECIALITY CARE, SOCIAL SERVICES, HOME CARE, ADULT DAY HEALTH CARE AND WIC PROGRAM 10 10 649 0 0 0 3931257 4359134 33073590 38628502 34740 83428 130757 159146 37170344 43230210 0 0 0 0 24551961 25979453 0 0 81566 16150610 17327796 40702571 43307249 -3532227 -77039 16225834 17378383 6023234 5323905 10202600 12054478 TO PROVIDE THE COMMUNITY WITH COMPREHENSIVE HEALTH CARE IN DORCHESTER, MA INCLUDING PRIMARY AND SPECIALTY CARE, HOME CARE, SOCIAL SERVICES, WOMEN, INFANT AND CHILD CARE, AND ADULT DAY HEALTH CARE. 0 0 39517755 38715158 COMPREHENSIVE COMMUNITY HEALTH CARE, PRIMARY & SPECIALITY CARE, SOCIAL SERVICES, HOMECARE, ADULT DAY HEALTH CARE AND WIC PROGRAM 39517755 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 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 1 0 0 0 1 136 0 1 649 1 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 MA X JAGDEEP TRIVEDI CHIEF EXECUTIVE OFFICER 6172878000 500 COLUMBIA ROAD DORCHESTER MA 02125 JAGDEEP TRIVEDI CHIEF EXECUTIVE OFFIC 35.00 X X 189108 0 7016 MARGARET LEAHY WIRTH PRESIDENT 0.00 X X 0 0 0 ALTHEA GARRISON VICE PRESIDENT 0.00 X X 0 0 0 WINIFRED PICKET AT-LARGE MEMBER 0.00 X X 0 0 0 DR CLARA LENNOX AT-LARGE MEMBER 0.00 X 0 0 0 MARIA FIGUEROA AT-LARGE MEMBER 0.00 X X 0 0 0 DAI MOREHOUSE TREASURER 0.00 X 0 0 0 TANYA CABRAL SECRETARY 0.00 X 0 0 0 ANDREA BURTON AT-LARGE MEMBER 0.00 X 0 0 0 CAROL SHAMSHAK AT-LARGE MEMBER 0.00 X 0 0 0 RAFAEL RIVERA AT-LARGE MEMBER 0.00 X 0 0 0 DR GEOFFREY MODEST PHYSICIAN 30.00 X 171019 0 19825 ELISE HENRICKS MEDICAL DIRECTOR 32.00 X 195190 0 8101 DR OLGA DELACALLE PHYSICIAN 35.00 X 171448 0 6728 DR ADAM BURROWS PHYSICIAN 35.00 X 223858 0 22068 CLAUDIA CLARKE PHYSICIAN 35.00 X 162809 0 11367 1113432 0 75105 19 0 1 0 DAW INC 298 UNION STREET LYNN MA 01901 PHARMACEUTICALS 2559579 BOSTON MEDICAL CENTER 840 HARRISON AVENUE BOSTON MA 02118 HEALTHCARE SERVICES 1194181 BOSTONIAN SKILLED NURSING & REHAB 389 ALDEN ROAD FAIRHAVEN MA 02719 SKILLED NURSING CARE FACILITY 728100 BENJAMIN HEALTHCARE CENTER 120 FISHER AVE ROXBURY MA 02120 MEDICAL CARE 634283 CPA MEDICAL BILLING LLC 20-1 THOMPSON ROAD BRANFORD CT 06405 MEDICAL BILLING 479258 16 1663431 2695703 4359134 PATIENT/INSURANCE FEES 621400 26074772 26074772 MEDICARE PAYMENTS 621400 12553730 12553730 38628502 83428 83428 194896 38978 155918 155918 155918 MISCELLANEOUS INCOME 621400 3228 3228 3228 43230210 38715158 0 155918 X 195899 195899 21474919 19211199 2196006 67714 2475644 2176426 291465 7753 1832991 1611447 215445 6099 69774 69774 78208 78208 247469 135157 112312 335797 307996 27801 74976 72405 2571 27115 27115 31528 31528 726009 666307 59702 DIRECT PATIENT SERVICES 8499942 8499942 MEDICAL SUPPLIES 1356303 1356303 BAD DEBTS 1162349 1162349 DATA PROCESSING FEES 852997 739891 113106 3865329 3519690 345639 43307249 39517755 3707928 81566 7329953 6950839 1564033 3532363 1153195 1107327 148249 264857 15608617 10085620 6030404 5522997 16225834 17378383 5257960 4639621 24318 31362 740956 652922 6023234 5323905 X 10033850 11885728 168750 168750 10202600 12054478 16225834 17378383 -77039 1928917 0 X X 0 0 0 X 3107026 3008003 3477246 3931257 4359134 17882666 29963809 31942616 34097069 33073590 38628502 167705586 33070835 34950619 37574315 37004847 42987636 185588252 1444257 1117134 1967568 1842375 2110818 8482152 407772 543321 951093 1852029 1660455 1967568 1842375 2110818 9433245 176155007 175218 180248 186396 213677 278324 1033863 175218 180248 186396 213677 278324 1033863 3811 779 19013 1547 3228 28378 33249864 35131646 37779724 37220071 43269188 186650493 0.94380 0.93850 0.00550 0.00530 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 32495 32495 11411884 6661934 4749950 4164238 3423686 740552 5522997 X 43269188 0 43269188 -38978 -38978 43230210 43346227 0 43346227 -38978 -38978 43307249 PART X, LINE 2: THE COMMITTEE BELIEVES THAT THEY HAVE APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -38,978. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -38,978. X X 0 0 0 0 0 0 0 0 0 JAGDEEP TRIVEDI CHIEF EXECUTIVE OFFIC 189108 0 0 0 0 0 0 0 7016 0 196124 0 0 0 DR GEOFFREY MODEST PHYSICIAN 171019 0 0 0 0 0 0 0 19825 0 190844 0 0 0 ELISE HENRICKS MEDICAL DIRECTOR 195190 0 0 0 0 0 0 0 8101 0 203291 0 0 0 DR OLGA DELACALLE PHYSICIAN 171448 0 0 0 0 0 0 0 6728 0 178176 0 0 0 DR ADAM BURROWS PHYSICIAN 223858 0 0 0 0 0 0 0 22068 0 245926 0 0 0 CLAUDIA CLARKE PHYSICIAN 162809 0 0 0 0 0 0 0 11367 0 174176 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE TAX RETURN IS REVIEWED BY THE CORPORATE ACCOUNTANT AND THE CHIEF EXECUTIVE OFFICER. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS HAVE COPIES OF THE CORPORATE BY-LAWS ADDRESSING CONFLICT OF INTEREST AND RECEIVE ORIENTATION AND TRAINING ON ALL ASPECTS OF THE POLICY. MANAGEMENT AND SUPERVISORY STAFF WITH AUTHORITY TO MAKE FINANCIAL OR PERSONNEL DECISIONS ALSO RECEIVE TRAINING. STAFF CAN ANONYMOUSLY FILE COMPLAINTS OR CONCERNS, OR BY VOICE MAIL OR DESIGNATED MAIL BOX THAT IS MONITORED BY THE ENTITY'S COMPLIANCE OFFICER FOR REVIEW AND RESOLUTION. FORM 990, PART VI, SECTION B, LINE 15 THE ENTITY'S BOARD OF DIRECTORS UTILIZES REPORTS ON SALARY/PAY SCALES AND BENEFIT INFORMATION PREPARED BY OUTSIDE CONSULTANTS THAT ARE ANNUALLY OBTAINED FROM THE MASSACHUSETTS LEAGUE OF COMMUNITY HEALTH CENTERS AND THE FOUNDATION OF HOME HEALTH. THESE REPORTS DETERMINE THE PAY OR SALARY RANGE OF EVERY POSITION IN THE CORPORATION INCLUDING ALL EXECUTIVES, DEPARTMENT HEADS, PHYSICIANS, NURSES, ADMINISTRATIVE STAFF AND ALL OTHER EMPLOYEES. THE PROPOSED SALARIES ARE THEN SUBMITTED TO THE BOARD DURING THE BUDGET PROCESS FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THIS INFORMATION IS AVAILABLE THROUGH THE CENTER'S WEBSITE FORM 990, PART IX, LINE 24E PATIENT TRANSPORTATION: PROGRAM SERVICE EXPENSES 644,678. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 644,678. BILLING SERVICES: PROGRAM SERVICE EXPENSES 479,258. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 479,258. RENTAL EXPENSES: PROGRAM SERVICE EXPENSES 382,726. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 382,726. RENTALS,REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 337,180. MANAGEMENT AND GENERAL EXPENSES 12,728. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 349,908. PATIENT MEALS: PROGRAM SERVICE EXPENSES 318,526. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 318,526. INSURANCE: PROGRAM SERVICE EXPENSES 131,089. MANAGEMENT AND GENERAL EXPENSES 80,053. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 211,142. LAB EXPENSES: PROGRAM SERVICE EXPENSES 200,173. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 200,173. VEHICLE EXPENSES: PROGRAM SERVICE EXPENSES 175,421. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 175,421. CONSULTANTS: PROGRAM SERVICE EXPENSES 50,904. MANAGEMENT AND GENERAL EXPENSES 113,153. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 164,057. DENTAL EXPENSES: PROGRAM SERVICE EXPENSES 148,401. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 148,401. EYE CARE SUPPLIES: PROGRAM SERVICE EXPENSES 141,962. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 141,962. TELEPHONE: PROGRAM SERVICE EXPENSES 114,401. MANAGEMENT AND GENERAL EXPENSES 11,354. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 125,755. PAYROLL FEES: PROGRAM SERVICE EXPENSES 93,234. MANAGEMENT AND GENERAL EXPENSES 12,818. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 106,052. PRINTING AND PUBLISHING: PROGRAM SERVICE EXPENSES 55,148. MANAGEMENT AND GENERAL EXPENSES 40,617. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 95,765. TRADE MEMBERSHIP DUES: PROGRAM SERVICE EXPENSES 93,466. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,466. RECRUITMENT: PROGRAM SERVICE EXPENSES 205. MANAGEMENT AND GENERAL EXPENSES 52,544. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,749. LICENSES & FEES: PROGRAM SERVICE EXPENSES 37,565. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,565. EDUCATIONAL SUPPLIES: PROGRAM SERVICE EXPENSES 37,538. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,538. POSTAGE & SHIPPING: PROGRAM SERVICE EXPENSES 19,092. MANAGEMENT AND GENERAL EXPENSES 2,624. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,716. MARKETING & ADVERTISING: PROGRAM SERVICE EXPENSES 19,922. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,922. BOARD & MEETING EXPENSES: PROGRAM SERVICE EXPENSES 6,994. MANAGEMENT AND GENERAL EXPENSES 12,689. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,683. SECURITY: PROGRAM SERVICE EXPENSES 16,520. MANAGEMENT AND GENERAL EXPENSES 2,535. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,055. INTERPRETING SERVICES: PROGRAM SERVICE EXPENSES 8,752. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,752. BOOKS & SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 609. MANAGEMENT AND GENERAL EXPENSES 4,524. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,133. FOOD & LODGING EXPENSES: PROGRAM SERVICE EXPENSES 4,678. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,678. PROGRAM TRAINING: PROGRAM SERVICE EXPENSES 716. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 716. HELP PROGRAM: PROGRAM SERVICE EXPENSES 532. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 532. PART XII, PAGE 12, LINE 2C THERE HAVE BEEN NO CHANGES FROM PRIOR YEAR PROCESS OF SELECTION OF INDEPENDENT AUDITORS OR AUDIT OVERSIGHT COLUMBIA MEDICAL GROUP INC 500 COLUMBIA ROAD DORCHESTER MA 02125 043317003 MEDICAL CARE, CURRENTLY INACTIVE MA 501(C)(3) LINE 12B, II N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0