2019-02-28T14:26:53-06:00 2018-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 191037341 990 2017-07-01 237354899 CHESPENN HEALTH SERVICES INC CHES 6104853800 1510 CHESTER PIKE NO 200 EDDYSTONE PA 19022 DANIEL CAPLAN FINANCE DIRECTOR 6104853800 2019-02-28 1 JULIUS C GREEN CPA P00350393 2159720701 X 216.255.126.197 2019-02-28 10:59:08 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 45D50D8E3994CEF8BF8842BFE43A81B55B26F885 2017 2019-02-21 02:37:17Z DANIEL CAPLAN 1510 CHESTER PIKE NO 200 EDDYSTONE PA 19022 11976701 0 X WWW.CHESPENN.ORG X 1972 PA CHESPENN HEALTH SERVICES OPERATES THREE COMPREHENSIVE HEALTH CENTERS LOCATED IN CHESTER AND DELAWARE COUNTIES. 10 10 120 10 0 313 3990080 3721480 7234651 8233321 6672 21900 0 0 11231403 11976701 0 0 0 0 6212109 6424686 0 0 0 4680100 5005307 10892209 11429993 339194 546708 8229219 7872255 3053219 2149547 5176000 5722708 X CHESPENN HEALTH SERVICES IS A NETWORK OF NON-PROFIT, FEDERALLY QUALIFIED HEALTH CENTERS THAT PROVIDES COMPREHENSIVE PRIMARY AND PREVENTIVE HEALTH CARE AND SOCIAL SERVICES TO MEDICALLY UNDERSERVED FAMILIES AND INDIVIDUALS ON A SLIDING SCALE. CHESPENN HEALTH SERVICES STRIVES TO MEET THE UNIQUE HEALTH NEEDS IN ITS COMMUNITIES IN LINGUISTICALLY AND CULTURALLY COMPETENT WAYS. 0 0 8990994 8233321 SINCE 1973, CHESPENN HEALTH SERVICES HAS PROVIDED COMPREHENSIVE FAMILY MEDICAL AND DENTAL CARE TO THE RESIDENTS OF CHESTER, PA AND NEIGHBORING COMMUNITIES. IN 2005, CHESPENN EXPANDED THESE HEALTH CARE SERVICES TO THE COATESVILLE AREA, AND IN 2009, CHESPENN OPENED THE CENTER FOR FAMILY HEALTH IN UPPER DARBY, PA. ADDITIONAL SERVICES THAT ARE OFFERED INCLUDE HOMELESS HEALTH CARE, FAMILY PLANNING SERVICES, OB/GYN, HIV/AIDS CARE, BEHAVIORAL HEALTH AND AN IN-HOUSE PHYSICIAN DISPENSARY. CHESPENN IS PRINCIPALLY FUNDED BY GRANTS FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. DURING THE 2017 TAX YEAR, CHESPENN RECEIVED TOTAL GRANT REVENUE OF $2,870,510.DURING THE 2017 TAX YEAR, CHESPENN HAD TOTAL ENCOUNTERS OF 50,259, OF WHICH 47,807 WERE BILLABLE. THE BILLABLE ENCOUNTERS CONSISTED OF THE FOLLOWING IN CHESTER, PA: 4,073 PEDIATRIC ENCOUNTERS, 13,695 ADULT ENCOUNTERS, AND 5,848 DENTAL ENCOUNTERS. IN ADDITION, THERE WERE 9,266 ENCOUNTERS AT THE UPPER DARBY ENTER FOR FAMILY HEALTH AND 14,925 ENCOUNTERS IN THE COATESVILLE SERVICE AREA. NON BILLABLE ENCOUNTERS CONSISTED OF 2,452 NURSE ONLY VISITS.CHESPENN PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE AMOUNTS DETERMINED TO BE CHARITY CARE ARE NOT REPORTED AS REVENUES. DURING THE 2017 TAX YEAR, CHESPENN PROVIDED CHARITY CARE OF APPROXIMATELY $1,131,000 TO PATIENTS. 8990994 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 26 0 120 1 1 1 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 PA X DANIEL A CAPLAN 6104853800 1510 CHESTER PIKE NO 200 EDDYSTONE PA 19022 WILLIE MAE WELLS PRESIDENT 1.00 0.00 X X 0 0 0 RAE ROEDER SECRETARY 1.00 0.00 X X 0 0 0 KAREN VESELY TREASURER 1.00 0.00 X X 0 0 0 CAROL ALLEN BOARD MEMBER 1.00 0.00 X 0 0 0 ANTHONY HALL BOARD MEMBER 1.00 0.00 X 0 0 0 DONNA LAWLER BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID KEITH BOARD MEMBER 1.00 0.00 X 0 0 0 JEFFREY GREEN BOARD MEMBER 1.00 0.00 X 0 0 0 GWEN SMITH BOARD MEMBER 1.00 0.00 X 0 0 0 DINA CAPALONGO BOARD MEMBER 1.00 0.00 X 0 0 0 MICHAEL G LUCAS PRESIDENT/CEO 40.00 0.00 X 209551 0 46139 KEVIN MCCABE MD PHYSICIAN 40.00 0.00 X 176417 0 10335 RAQUIBUL ISLAM MD PHYSICIAN 40.00 0.00 X 156711 0 21909 CYNTHIA LACAPRA MD PHYSICIAN 40.00 0.00 X 150294 0 13937 NANCY KOSHETAR DENTIST 39.50 0.00 X 133884 0 12587 SOFIA BARROSO DENTIST 39.50 0.00 X 131248 0 16265 958105 0 121172 9 0 1 0 PROSPECT HEALTH ACCESS NETWORK ONE MEDICAL CENTER BLVD UPLAND PA 19013 CONTRACTED PHYSICIAN SERVICES 1649683 TARGET BUILDING CONSTRUCTION 1124 CHESTER PIKE CRUM LYNNE PA 19022 BUILDING CONTRACTOR 479096 COORDINATED CARE NETWORK 300 PENN CENTER BLVD PITTSBURGH PA 15235 CONTRACTED PHARMACY SERVICES 366638 MCKESSON CORPORATION 1 JOHN HENRY DRIVE ROBBINSVILLE NJ 08691 MEDICAL & PHARMACEUTICAL SUPPLIES 224772 CALL 4 HEALTH 2855 S CONGRESS AVENUE DELRAY BEACH FL 33445 CALL CENTER SERVICE 176747 8 90007 2870510 760963 3721480 NET PATIENT SERVICE REVENUE 621400 8233321 8233321 8233321 21900 21900 11976701 8233321 0 21900 X 270596 270596 5022095 4121232 900863 239940 195803 44137 483626 389973 93653 408429 323336 85093 19771 19771 63965 13244 50721 1987810 1742603 245207 7027 2807 4220 394832 277491 117341 301813 6439 295374 875998 713931 162067 48798 23694 25104 15995 15995 206273 198185 8088 30252 19722 10530 PATIENT CARE 778067 773717 4350 PROVISION FOR DOUBTFUL 143318 143318 EQUIPMENT RENTAL 51434 33903 17531 DUES AND SUBSCRIPTIONS 36747 140 36607 43207 11456 31751 11429993 8990994 2438999 0 259365 288961 5580411 5270657 112680 157611 748578 647838 9801 9152 105259 58447 4993725 3554136 1413125 1439589 8229219 7872255 2097308 1200862 93750 83333 500000 862161 365352 3053219 2149547 X 5176000 5722708 5176000 5722708 8229219 7872255 546708 0 X 0 1 X 1 0 X 3029337 3859067 4095923 3990080 3721480 18695887 5871117 7443999 7644227 7234651 8233321 36427315 8900454 11303066 11740150 11224731 11954801 55123202 0 0 0 55123202 2118 1877 2443 6672 21900 35010 2118 1877 2443 6672 21900 35010 8902572 11304943 11742593 11231403 11976701 55158212 0.99940 0.99960 0.00060 0.00040 X 100838 100838 3153067 1885240 1267827 349794 310114 39680 1341554 1310310 31244 48472 48472 0 1439589 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 365352 365352 X 11976701 0 11976701 0 11976701 11429993 0 11429993 0 11429993 PART X, LINE 2: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2018 AND 2017. X X X 0 0 0 0 0 0 0 1 0 MICHAEL G LUCAS PRESIDENT/CEO 209551 0 0 0 0 0 36191 0 9948 0 255690 0 0 0 KEVIN MCCABE MD PHYSICIAN 174215 0 2202 0 0 0 8821 0 1514 0 186752 0 0 0 RAQUIBUL ISLAM MD PHYSICIAN 154653 0 2058 0 0 0 8235 0 13674 0 178620 0 0 0 CYNTHIA LACAPRA MD PHYSICIAN 148388 0 1906 0 0 0 7624 0 6313 0 164231 0 0 0 PART I, LINE 7 THE BOARD OF DIRECTORS APPROVES AN ANNUAL STRATEGIC PLAN FOR THE ORGANIZATION. THE BONUS IS BASED ON THE ACHIEVEMENT OF THE INDIVIDUAL CORPORATE GOALS IN THE STRATEGIC PLAN. FORM 990, PART VI, SECTION A, LINE 1 KEY FINANCIAL DECISIONS AND REPORTS ARE APPROVED BY THE FINANCE COMMITTEE AND THEN PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. MEMBERS OF THE FINANCE COMMITTEE ARE ALSO MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 3 CROZER KEYSTONE HEALTH SYSTEM PROVIDES CONTRACTED PHYSICIAN AND INFORMATION TECHNOLOGY SERVICES. FORM 990, PART VI, SECTION B, LINE 11B THE FINAL 990 RETURN WAS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE ALONG WITH THE BOARD OF DIRECTORS OF CHESPENN HEALTH SERVICES. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS MUST ANNUALLY SIGN THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS ARE ALSO REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST THAT MAY ARISE DURING THE YEAR AND MUST REFRAIN FROM DISCUSSING, AS WELL AS VOTING ON, SUCH MATTERS THAT PERTAIN TO THE CONFLICT. EMPLOYEES OF THE ORGANIZATION ARE ALSO REQUIRED TO REPORT ANY POTENTIAL OR ACTUAL CONFLICT TO THE PRESIDENT/CEO. THE PRESIDENT/CEO IS RESPONSIBLE FOR MONITORING AND RESOLVING ANY CONFLICT OF INTEREST THAT MAY ARISE WITHIN THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 TO DETERMINE THE SALARY OF THE PRESIDENT/CEO, CHESPENN HEALTH SERVICES RELIES ON SURVEY INFORMATION FROM TWO SOURCES. THE FIRST SOURCE IS AN ANNUAL SURVEY CONDUCTED BY THE HOSPITAL AND THE HEALTHCARE COMPENSATION SERVICE FOR THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS WHICH CATEGORIZES ALL COMMUNITY HEALTH CENTERS BY SERVICE LEVEL, GEOGRAPHY AND, BUDGET. THE SECOND SOURCE IS THE IRS FORM 990 IN WHICH A COMPENSATION SURVEY OF REGIONAL COMMUNITY HEALTH CENTERS IS CONDUCTED. BOTH SOURCES OF INFORMATION ARE USED BY CHESPENN HEALTH SERVICES' BOARD OF DIRECTORS TO DETERMINE THE COMPENSATION LEVEL. THIS COMPENSATION REVIEW IS CONDUCTED ON AN ANNUAL BASIS TO ASSURE THAT COMPENSATION IS IN LINE WITH FAIR MARKET VALUE, AND THE PROCESS IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIANS, DENTAL, INTERPRETING: PROGRAM SERVICE EXPENSES 1,742,603. MANAGEMENT AND GENERAL EXPENSES 245,207. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,987,810. FORM 990, PART VI, SECTION B, LINE 13: THE ORGANIZATION IS CURRENTLY DEVELOPING A WHISTLEBLOWER POLICY WHICH IS EXPECTED TO BE APPROVED BY THE BOARD IN FISCAL YEAR 2019.