2018-01-29T10:58:36-06:00 2017-06-30 390859910 Baker Tilly Virchow Krause LLP 1650 Market Street Suite 4500 Philadelphia PA 191037341 990 2016-07-01 237354899 CHESPENN HEALTH SERVICES INC CHES 6104853800 1510 Chester Pike No 200 Eddystone PA 19022 MICHAEL G LUCAS President/CEO 6104853800 2018-01-29 1 Julius C Green CPA P00350393 2159720701 X 216.255.126.197 2018-01-29 10:34:53 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B61FA1639B1C05FB95829B38B50E43F553865046 2016 2021-01-29 14:40:06Z X Michael G Lucas 1510 Chester Pike No 200 Eddystone PA 19022 11231403 0 X WWW.CHESPENN.COM X 1972 PA CHESPENN HEALTH SERVICES OPERATES THREE COMPREHENSIVE HEALTH CENTERS LOCATED IN CHESTER AND DELAWARE COUNTIES. 8 8 135 9 0 0 4095923 3990080 7644227 7234651 2443 6672 0 0 11742593 11231403 0 0 0 0 6598496 6212109 0 0 0 4588765 4680100 11187261 10892209 555332 339194 6292995 8229219 1456189 3053219 4836806 5176000 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 8608195 7234651 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 2016 TAX YEAR, CHESPENN RECEIVED TOTAL GRANT REVENUE OF $2,932,714.DURING THE 2016 TAX YEAR, CHESPENN HAD TOTAL ENCOUNTERS OF 51,310, OF WHICH 47,304 WERE BILLABLE. THE BILLABLE ENCOUNTERS CONSISTED OF THE FOLLOWING IN CHESTER, PA: 6,208 PEDIATRIC ENCOUNTERS, 10,476 ADULT ENCOUNTERS, AND 6,211 DENTAL ENCOUNTERS. IN ADDITION, THERE WERE 9,180 ENCOUNTERS AT THE UPPER DARBY ENTER FOR FAMILY HEALTH AND 15,229 ENCOUNTERS IN THE COATESVILLE SERVICE AREA. NON BILLABLE ENCOUNTERS CONSISTED OF 4,006 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 2016 TAX YEAR, CHESPENN PROVIDED CHARITY CARE OF APPROXIMATELY $1,194,000 TO PATIENTS. 8608195 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 1 135 1 0 0 0 0 0 0 0 0 0 0 X 8 8 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 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 Michael G Lucas President/CEO 40.00 0.00 X 214655 0 36174 KEVIN MCCABE MD PHYSICIAN 40.00 0.00 X 168765 0 9809 RAQUIBUL ISLAM MD PHYSICIAN 40.00 0.00 X 153040 0 19394 CYNTHIA LACAPRA MD PHYSICIAN 40.00 0.00 X 146280 0 13562 MICHAEL KANE DENTIST 39.50 0.00 X 135057 0 7858 VINCENT DEPANICIS DENTIST 39.50 0.00 X 132343 0 12616 950140 0 99413 10 0 1 0 COORDINATED CARE NETWORK 300 PENN CENTER BLVD PITTSBURGH PA 15235 CONTRACTED PHARMACY SERVICES 342751 PROSPECT HEALTH ACCESS NETWORK ONE MEDICAL CENTER BLVD UPLAND PA 19013 CONTRACTED PHYSICIAN SERVICES 200027 NO BOUNDARIES - LANGUAGE & INTERPRETING 475 TIMBERLINE TRL WEST CHESTER PA 19382 TRANSLATION SERVICES 153254 THE CHESTER COUNTY HOSPITAL 701 EAST MARSHALL STREET WEST CHESTER PA 19380 CONTRACTED PHYSICIAN SERVICES 116025 GE HEALTHCARE IITS USA CORP 15724 COLLECTIONS CTR DR CHICAGO IL 60693 INFORMATION TECHNOLOGY SERVICES 105853 5 130661 2932714 926705 3990080 Net Patient Service Revenue 621400 7234651 7234651 7234651 6672 6672 11231403 7234651 0 6672 X 260233 260233 4873808 3909637 964171 226510 208293 18217 451542 372570 78972 400016 328267 71749 18279 18279 63929 12984 50945 1821990 1591257 230733 5019 300 4719 351846 284903 66943 332319 35417 296902 930170 853151 77019 51601 38594 13007 220951 194289 26662 30669 14983 15686 Patient Care 590772 585065 5707 PROVISION FOR DOUBTFUL 126161 126161 Equipment Rental 52680 31378 21302 DUES AND SUBSCRIPTIONS 40272 1904 38368 43442 19042 24400 10892209 8608195 2284014 0 235732 259365 3644794 5580411 162527 112680 598593 748578 25500 9801 107959 105259 4760989 3347864 1353361 1413125 164529 0 6292995 8229219 1277022 2097308 179167 93750 0 862161 1456189 3053219 X 4836806 5176000 4836806 5176000 6292995 8229219 339194 0 X 0 1 X 1 1 1 X 2753950 3029337 3859067 4095923 3990080 17728357 5242581 5871117 7443999 7644227 7234651 33436575 7996531 8900454 11303066 11740150 11224731 51164932 0 0 0 51164932 5454 2118 1877 2443 6672 18564 5454 2118 1877 2443 6672 18564 8001985 8902572 11304943 11742593 11231403 51183496 0.99960 0.99960 0.00040 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 100838 100838 2673971 1739012 934959 596154 276244 319910 1341554 1284136 57418 48472 48472 0 1413125 Estimated third-party payor settlements 862161 862161 X 11231403 0 11231403 0 11231403 10892209 0 10892209 0 10892209 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 2017 and 2016. The Corporation does not perform any activities that would be subject to unrelated business income tax; therefore, it has not filed Form 990-T, Exempt Organization Business Income Tax Return. X X X 0 0 0 0 0 0 0 1 0 Michael G Lucas President/CEO 203013 0 11642 0 0 0 27233 0 8941 0 250829 0 0 0 KEVIN MCCABE MD PHYSICIAN 165653 0 3112 0 0 0 8438 0 1371 0 178574 0 0 0 RAQUIBUL ISLAM MD PHYSICIAN 149965 0 3075 0 0 0 7652 0 11742 0 172434 0 0 0 CYNTHIA LACAPRA MD PHYSICIAN 143419 0 2861 0 0 0 7314 0 6248 0 159842 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 organization's 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 1,591,257. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,591,257. grant writing & consulting, billing, IT: Program service expenses 0. Management and general expenses 230,733. Fundraising expenses 0. Total expenses 230,733. 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 2017.