2016-11-15T08:54:25-06:00 2015-12-31 221478099 COHNREZNICK LLP 1212 Avenue of the Americas New York NY 10036 990 2015-01-01 132739694 CHARLES B WANG COMMUNITY HEALTH CENTER INC CHAR 2123796988 268 CANAL STREET NEW YORK NY 10013 jane t eng CEO 2123796988 2016-10-28 1 THOMAS LANNING P00851654 2122970400 2015 2017-02-10 21:41:12Z jane t eng 268 CANAL STREET NEW YORK NY 10013 73381104 0 X www.cbwchc.org X 1972 NY THE MISSION OF THE CHARLES B. WANG COMMUNITY HEALTH CENTER IS TO ELIMINATE DISPARITIES IN HEALTH, IMPROVE HEALTH STATUS, AND EXPAND ACCESS TO THE MEDICALLY UNDERSERVED WITH A FOCUS ON ASIAN AMERICANS. 17 16 666 21 0 0 7983805 11801408 40729849 41240565 154698 -188675 3624821 4018303 52493173 56871601 0 0 0 0 36343689 38190421 0 0 0 12164831 13566197 48508520 51756618 3984653 5114983 53769178 59878844 10272241 10887984 43496937 48990860 THE MISSION OF THE CHARLES B WANG COMMUNITY HEALTH CENTER IS TO ELIMINATE DISPARITIES IN HEALTH, IMPROVE HEALTH STATUS, AND EXPAND ACCESS TO THE MEDICALLY UNDERSERVED WITH A FOCUS ON ASIAN AMERICAN. 0 0 44723955 45221411 The organization operated a federally qualified health center, which had 237,617 visits in 2015. 44723955 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 26 0 1 666 1 0 0 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X LYNN D SHERMAN 2123796988 268 CANAL STREET NEW YORK NY 10013 Chun K Yip MD Vice Chairperson 3.00 X X 0 0 0 Emily Woo Board Member 2.00 X 0 0 0 Irene Chu Board Member 2.00 X 0 0 0 James Wong Treasurer 3.00 X X 0 0 0 Jeanne Lee Jackson Board Member 2.00 X 0 0 0 Jiming Liang Board Member 2.00 X 0 0 0 Kenneth Shieh OUTgoing Board Member 2.00 X 0 0 0 Kenny Chin Esq Chairperson 4.00 X X 0 0 0 Leslie Chuang MD Board Member 2.00 X 0 0 0 Marie Lam Board Member 2.00 X 0 0 0 MARY AGNES PAN Secretary 3.00 X X 0 0 0 Pauline Tse Board Member 2.00 X 0 0 0 ROBERT BELL Board Member 2.00 X 0 0 0 Sophia Ng Board Member 2.00 X 0 0 0 Stephanie Cheng Board Member 2.00 X 0 0 0 Timothy Hsu Board Member 2.00 X 0 0 0 Victor Lee outgoing Board Member 2.00 X 0 0 0 William Tam Board Member 2.00 X 0 0 0 Yvonne Ghaw Board Member 2.00 X 0 0 0 Betty K Cheng Chief Operating Officer 35.00 X 216483 0 14849 JANE T ENG ESQ Chief Executive Officer 35.00 X 331966 0 40581 Lynn D Sherman Chief Financial Officer 35.00 X 236653 0 40017 PERRY PONG MD Chief Medical Officer 35.00 X 287871 0 41234 REGINA F LEE ESQ Chief Development Officer 35.00 X 215347 0 23366 Shao-Chee Sim Chief Strategy Officer 35.00 X 180299 0 21161 ALLAN HO MD Chief of OBGYN 35.00 X 393068 0 25324 CHRISTINE J SHEN MD Senior Pediatrician II 35.00 X 345373 0 31282 JIAN-PING CHEN MD MD of Mental Health 35.00 X 305774 0 39978 JIE YING SHEN MD Senior Pediatrician II 35.00 X 415570 0 33256 Shimin Cao md Section Chief of internal medicine 35.00 X 294204 0 36253 3222608 0 347301 65 0 1 0 Proskauer Rose LLP Eleven Times Square New York NY 10036 Legal Services 138425 1 9913757 1887651 1841199 11801408 NEW YORK STATE MEDICAID MANAGED C 621400 17978194 17978194 Medicaid managed care 621400 9199141 9199141 private insurance 621400 7301637 7301637 Medicaid 621400 3538385 3538385 new york state uncompensated care 621400 1121449 1121449 2101759 2101759 41240565 322058 322058 15998770 16509503 -510733 -510733 -510733 HEALTH PLAN QUALITY DISTRIBUTION 900099 2337220 2337220 340b pharmacy 900099 607277 607277 meaningful use incentive 900099 416500 416500 657306 619849 37457 4018303 56871601 45221411 0 -151218 1649826 1434881 214945 28569911 24847729 3722182 1155856 1005267 150589 4565299 3970517 594782 2249529 1956454 293075 199190 199190 107180 107180 632142 310539 321603 776695 680940 95755 3913396 3334213 579183 375775 326818 48957 229342 199463 29879 1194421 1017647 176774 149091 70130 78961 Donated vaccines 1841199 1841199 Pharmaceuticals 1445711 1445711 Consumable supplies 758676 674973 83703 Laboratory and radiolog 661254 661254 1282125 946220 335905 51756618 44723955 7032663 0 85696 1067781 14121412 22686603 1114911 1048641 4924877 5631240 527870 500652 27791864 14084108 13636297 13707756 15341554 10466562 4016561 4769609 53769178 59878844 6309935 6922986 78050 0 3884256 3964998 10272241 10887984 X 42980270 48553485 516667 437375 43496937 48990860 53769178 59878844 5114983 378940 0 X X 0 1 X 1 1 1 X 8241051 7778579 7891204 7989685 11801408 43701927 29869824 33320653 45662634 40729849 41240565 190823525 38110875 41099232 53553838 48719534 53041973 234525452 0 0 0 234525452 33246 40334 35213 154698 322058 585549 33246 40334 35213 154698 322058 585549 305808 595933 519145 3624821 4018303 9064010 38449929 41735499 54108196 52499053 57382334 244175011 0.96050 0.97490 0.00240 0.00140 X Schedule A, Part III, Line 12, Explanation of Other Income: Health plan quality distribution - 2014 Amount: $ 1,957,315. 2015 Amount: $ 2,337,220. Meaningful use incentive - 2014 Amount: $ 463,250. 2015 Amount: $ 416,500. 340 b pharmacy - 2014 Amount: $ 490,553. 2015 Amount: $ 607,277. Management services fees - 2011 Amount: $ 210,769. 2012 Amount: $ 217,662. 2013 Amount: $ 230,562. 2014 Amount: $ 238,555. 2015 Amount: $ 243,654. Metrocard reimbursement - 2014 Amount: $ 239,803. 2015 Amount: $ 364,095. Medical records charges - 2011 Amount: $ 5,015. 2013 Amount: $ 22,731. 2014 Amount: $ 27,520. 2015 Amount: $ 37,457. Other - 2012 Amount: $ 5,445. 2013 Amount: $ 265,852. 2014 Amount: $ 207,825. 2015 Amount: $ 12,100. insurance plan proceeds - 2012 Amount: $ 308,031. miscellaneous income - 2011 Amount: $ 90,024. 2012 Amount: $ 64,795. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 19332207 6755114 12577093 5377880 4585512 792368 3081777 2743482 338295 13707756 SECURITY DEPOSITS 1330613 DEFERRED COMPENSATION ACCOUNT 3438996 4769609 DEFERRED COMPENSATION PAYABLE 3438996 DEFERRED RENT 526002 3964998 X 57254651 378940 4110 383050 56871601 0 56871601 51760728 4110 4110 51756618 0 51756618 Part X, Line 2: The Center has no unrecognized tax benefits at December 31, 2015. The Center's Federal and state income tax returns prior to fiscal year 2012 are closed and management continually evaluates expiring statutes of limitations, audits, proposed settlements, changes in tax law and new authoritative rulings. The Center recognizes interest and penalties associated with tax matters as operating expenses and includes accrued interest and penalties with accrued expenses in the statement of financial position. X X X X 0 0 0 0 0 0 0 1 0 Betty K Cheng Chief Operating Officer 196899 0 0 0 19584 0 12894 0 1955 0 231332 0 0 0 JANE T ENG ESQ Chief Executive Officer 305876 0 6375 0 19715 0 15900 0 24681 0 372547 0 0 0 Lynn D Sherman Chief Financial Officer 217621 0 0 0 19032 0 14379 0 25638 0 276670 0 0 0 PERRY PONG MD Chief Medical Officer 287319 0 0 0 552 0 15595 0 25638 0 329104 0 0 0 REGINA F LEE ESQ Chief Development Officer 194299 0 0 0 21048 0 12894 0 10472 0 238713 0 0 0 Shao-Chee Sim Chief Strategy Officer 179999 0 0 0 300 0 0 0 21161 0 201460 0 0 0 ALLAN HO MD Chief of OBGYN 374516 0 0 0 18552 0 15900 0 9424 0 418392 0 0 0 CHRISTINE J SHEN MD Senior Pediatrician II 327058 0 0 0 18315 0 7204 0 24078 0 376655 0 0 0 JIAN-PING CHEN MD MD of Mental Health 287222 0 0 0 18552 0 15900 0 24078 0 345752 0 0 0 JIE YING SHEN MD Senior Pediatrician II 397051 0 0 0 18519 0 7618 0 25638 0 448826 0 0 0 Shimin Cao md Section Chief of internal medicine 293172 0 0 0 1032 0 10615 0 25638 0 330457 0 0 0 Part I, Line 7 INCLUDED ON SCHEDULE J, PART II, COLUMN B(II) ARE AMOUNTS REPRESENTING productivity based incentives. THESE AMOUNTS WERE INCLUDED IN THE INDIVIDUALS 2015 W-2S AND were set by benchmarks in the individuals contracts. SCHEDULE J, PART II: A PORTION OF THE AMOUNT PRESENTED IN COLUMN B(III) FOR Allan Ho, Christine J. Shen, Jian-Ping Chen, Jie Ying Shen, Shimin Cao, Regina F. Lee, Betty K. Cheng, Jane T. Eng, and Lynn D. Sherman REPRESENT AMOUNTS DEFERRED INTO A QUALIFIED RETIREMENT PLAN. CENTRE COURT HOLDINGS LLC Irene Chu, Board member, has a financial interest in Centre Court Holdings, 383208 RENT 0 X 1 1841199 COST 0 0 0 Part I, Column (b): COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS. Form 990, Part VI, Section B, line 11 COPIES OF THE FORM 990 ARE DISTRIBUTED THE BOARD OF DIRECTORS. IT IS REVIEWED BY SENIOR MANAGEMENT, INCLUDING THE CEO AND CFO, AND THE BOARD FINANCE COMMITTEE, WHO PRESENT IT TO THE BOARD OF DIRECTORS FOR A VOTE BEFORE IT IS FILED WITH THE IRS. Form 990, Part VI, Section B, line 12c THE ORGANIZATION'S DIRECTORS, OFFICERS AND KEY EMPLOYEES SIGN DISCLOSURE STATEMENTS ANNUALLY. THE BOARD DEVELOPMENT COMMITTEE IS RESPONSIBLE FOR MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IN THE EVENT A CONFLICT EXISTS, THE INDIVIDUAL WITH THE CONFLICT MUST RECUSE HIMSELF/HERSELF FROM ANY DELIBERATION AND VOTING REGARDING THE CONFLICT. Form 990, Part VI, Section B, line 15a ANNUALLY, THE compensation COMMITTEE OF THE BOARD REVIEWS AND EVALUATES THE CEO AND DECIDES ON COMPENSATION. INFORMATION FROM OUTSIDE CONSULTANTS ON COMPARABLE SALARIES OF SIMILAR ORGANIZATIONS MAY BE USED IN THEIR DETERMINATION. SALARIES FOR OTHER OFFICERS & KEY EMPLOYEES ARE DETERMINED BY THE CEO, USING SALARY SURVEYS WITH INFORMATION FROM OTHER HEALTH CENTERS, AS WELL AS EMPLOYEE ANNUAL EVALUATIONS. Form 990, Part VI, Section C, line 19 COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AREAVAILABLE UPON REQUEST. form 990, part XII, line 2c: No change from prior period process.