2017-11-13T11:57:19-06:00 2016-12-31 113518842 MARKS PANETH LLP 685 THIRD AVENUE NEW YORK NY 10017 990 2016-01-01 141588402 MIDDLETOWN COMMUNITY HEALTH CENTER INC MIDD 8453437614 21 ORCHARD STREET MIDDLETOWN NY 10940 SYBIL MEDINA INTERIM CEO 8453437614 2017-11-13 1 ROBERT LYONS P00227472 2125038800 69.74.165.34 2017-11-13 12:36:16 ES P DF616C45020760B98F5E40A9976ADF8FF2F9381D B8E8917F0931719FE7A109CCAA1C726E9AF7A481 2016 2018-03-14 21:41:22Z SYBIL MEDINA 21 ORCHARD STREET MIDDLETOWN NY 10940 12542179 0 X MCHCCARES.ORG X 1977 NY MIDDLETOWN COMMUNITY HEALTH CENTER, INC IS A NON-PROFIT COMMUNITY BASED ORGANIZATION THAT IS COMMITTED TO THE PROVISION OF HIGH QUALITY, COMPREHENSIVE AND AFFORDABLE HEALTH CARE SERVICES TO ALL MEMBERS OF THE COMMUNITY IN ORDER TO ENHANCE THE QUALITY OF LIFE OF PATIENTS, FAMILIES AND THE COMMUNITY AS A WHOLE. 9 9 248 9 0 0 3673261 3799501 9162722 8319737 204165 111 178972 422830 13219120 12542179 0 0 0 0 9717617 9778579 0 0 0 3516172 3608093 13233789 13386672 -14669 -844493 5100717 4397367 2889348 3247369 2211369 1149998 X MIDDLETOWN COMMUNITY HEALTH CENTER, INC IS A NON-PROFIT COMMUNITY BASED ORGANIZATION THAT IS COMMITTED TO THE PROVISION OF HIGH QUALITY, COMPREHENSIVE AND AFFORDABLE HEALTH CARE SERVICES TO ALL MEMBERS OF THE COMMUNITY IN ORDER TO ENHANCE THE QUALITY OF LIFE OF PATIENTS, FAMILIES AND THE COMMUNITY AS A WHOLE. 0 0 11202107 8319737 MEDICAL MCHC SERVED THOUSANDS OF PATIENTS IN 2016, WITH AN EMPHASIS ON PROVIDING QUALITY HEALTHCARE TO PEOPLE ACROSS THE LIFESPAN OF EVERY GENDER, RELIGION, SEXUAL ORIENTATION, AND SOCIOECONOMIC STATUS. 11202107 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 1 0 0 0 0 0 0 0 0 1 22 0 248 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X SYBIL MEDINA INTERIM CEO 8453437614 21 ORCHARD STREET MIDDLETOWN NY 10940 JOSEPH PALUGHI CHAIRMAN 1.00 X X 0 0 0 STEFANIE HUBERT VICE CHAIR 1.00 X X 0 0 0 JOHN KLASSEN TREASURER 1.00 X X 0 0 0 CORNELIA HARVEY SECRETARY 1.00 X X 0 0 0 MARGARET BOGERT BOARD MEMBER (FORMER) 1.00 X 0 0 0 LISA ECHEVARRIA BOARD MEMBER 1.00 X 0 0 0 DEBORA VALENTINE BOARD MEMBER 1.00 X 0 0 0 MATTHEW D WITHEROW BOARD MEMBER 1.00 X 0 0 0 EMILY HERRERA BOARD MEMBER 1.00 X 0 0 0 AJAY PATEL BOARD MEMBER (FORMER) 1.00 X 0 0 0 MARK CAPICOTTO BOARD MEMBER (FORMER) 1.00 X 0 0 0 YUDELKA BALERIO-HERRERA BOARD MEMBER 1.00 X 0 0 0 THERESA BUTLER CHIEF EXECUTIVE OFFICER 35.00 X 219506 0 25104 ALICIA TENNY CHIEF FINANCIAL OFFICER 35.00 X 131151 0 27335 SYBIL MEDINA CHIEF PROGRAM OFFICER 35.00 X 100954 0 27247 JOSEPH LANZA CHIEF MEDICAL OFFICER 35.00 X 229361 0 8829 LYNNE DICOSTANZO PHYSICIAN 35.00 X 209882 0 8748 NILA SINGARAVELU PHYSICIAN 35.00 X 187773 0 19583 LINDA MENDELSOHN PHYSICIAN 35.00 X 160329 0 1400 SADIA KHANDAKER PHYSICIAN 35.00 X 177827 0 8822 1416783 0 127068 8 0 1 0 SUCCESS EHS 100 GREENWAY BLVD CARROLLTON GA 30117 CONSULTANT 335180 TIME WARNER CABLE TIME WARNER CABLE BUILDING SUITE BUFFALO NY 14270 INTERNET & PHONE SERVICE 129825 ORANGE & ROCKLAND 1 BLUE HILL PLAZA PEARL RIVER NY 10965 UTILITIES 106907 7 3774026 25475 362976 3799501 MANAGED CARE 621110 7985985 7985985 PUBLIC GOODS 621110 333752 333752 8319737 111 111 INSURANCE INCENTIVES 900099 257693 257693 OTHER REVENUE 900099 165137 165137 422830 12542179 8319737 0 422941 769488 178642 590846 7743050 7014545 728505 550835 513074 37761 715206 596935 118271 64520 64520 478014 340692 137322 435453 350989 84464 481043 387736 93307 73237 38692 34545 58578 47216 11362 469234 378217 91017 92810 92810 BAD DEBT EXPENSE 595055 595055 DONATED VACCINES 362976 362976 REPAIRS & MAINT. 235222 189596 45626 TELEPHONE 202538 163252 39286 59413 44490 14923 13386672 11202107 2184565 0 182001 159317 242785 208329 1284737 1313035 148219 157027 7662693 5103034 3242975 2559659 5100717 4397367 1467014 1929488 1313059 1278996 109275 38885 2889348 3247369 X 2211369 1149998 2211369 1149998 5100717 4397367 X -844493 -216878 X X 0 1 X 1 1 1 X 2275224 2424235 4075345 3673261 3799501 16247566 2275224 2424235 4075345 3673261 3799501 16247566 16247566 21495 48564 91376 204165 257804 623404 3506 464654 208250 178972 165137 1020519 17891489 45064887 0.90810 0.96010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 423715 423715 3791586 2549458 1242128 327620 144026 183594 3119772 2409550 710222 2559659 DEFERRED RENT 38885 38885 X 11947124 0 11947124 595055 595055 12542179 13603550 216878 216878 13386672 0 13386672 PART X, LINE 2: THE CENTER BELIEVES IT HAS NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2016 AND 2015 IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION ("ASC") TOPIC 740 ("INCOME TAXES"), WHICH PROVIDES STANDARDS FOR ESTABLISHING AND CLASSIFYING ANY TAX PROVISIONS FOR UNCERTAIN TAX POSITIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: UNCOLLECTABLE ACCOUNTS 595,055. X X X 0 0 0 0 0 0 0 0 0 THERESA BUTLER CHIEF EXECUTIVE OFFICER 214506 0 5000 0 0 0 0 0 25104 0 244610 0 0 0 ALICIA TENNY CHIEF FINANCIAL OFFICER 126151 0 5000 0 0 0 0 0 27335 0 158486 0 0 0 JOSEPH LANZA CHIEF MEDICAL OFFICER 229361 0 0 0 0 0 0 0 8829 0 238190 0 0 0 LYNNE DICOSTANZO PHYSICIAN 209882 0 0 0 0 0 0 0 8748 0 218630 0 0 0 NILA SINGARAVELU PHYSICIAN 187773 0 0 0 0 0 0 0 19583 0 207356 0 0 0 LINDA MENDELSOHN PHYSICIAN 160329 0 0 0 0 0 0 0 1400 0 161729 0 0 0 SADIA KHANDAKER PHYSICIAN 177827 0 0 0 0 0 0 0 8822 0 186649 0 0 0 X 13 362976 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY INDEPENDENT ACCOUNTING FIRM AND IS REVIEWED BY MANAGEMENT PRIOR TO SUBMISSION AND DISTRIBUTED TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION EMPLOYS A CORPORATE COMPLIANCE COORDINATOR WHO REVIEW AND MAINTAINS THE CONFLICT OF INTEREST STATEMENTS THAT ARE RECEIVED ANNUALLY FROM THE EXECUTIVE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15A THE HR DIRECTOR COLLECTS VARIOUS SALARY SURVEYS FROM THE STATE'S PRIMARY CARE ASSOCIATION, NACHC, 990S OF OTHER FQHCS, AND THE INTERNET FOR CEOS IN SIMILAR CAPACITIES. THIS INFORMATION IS THEN PROVIDED TO THE BOARD OF DIRECTORS WHO ANALYZE THE DATA AND MAKE A DECISION ON WHAT IS CONSIDERED FAIR COMPENSATION FOR THE CEO. FOR EVERY ONE ELSE, THE ORGANIZATION USES VARIOUS THIRD PARTY DATA LIKE SALARY SURVEYS FROM THE STATE'S PRIMARY CARE ASSOCIATION, NACHC, 990S, AND THE INTERNET. THE CEO USES THIS INFORMATION TO MAKE A DECISION ON EMPLOYEES SALARY. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: WRITE OFF FIXED ASSETS -216,878. FORM 990, PART XII, LINE 2C: RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT HAS NOT BEEN CHANGED FROM THE PRIOR YEAR.