2016-11-15T17:19:38-06:00 2015-12-31 202153727 SB & COMPANY LLC 200 INTERNATIONAL CIRCLE SUITE 5500 HUNT VALLEY MD 21030 990 2015-01-01 461962771 YOUR HEALTH NETWORK INC YOUR 4434750990 3000 FALLS ROAD SUITE 1 BALTIMORE MD 21211 PETER L BEILENSON MD MPH CHAIRMAN OF THE BOARD 4434750990 2016-11-15 1 SHEILA EICHELBERGER P00743897 4105840060 2016-11-15 2015 2017-02-10 21:41:12Z EVERGREEN HEALTH CARE ELIZABETH BURGER MUNFA 3000 FALLS ROAD SUITE 1 BALTIMORE MD 21211 2381443 0 X EVERGREENMD.ORG X 2012 MD TO PROVIDE PATIENT-CENTERED HIGH QUALITY HEALTH AND WELLNESS SERVICES THAT DEEPLY ENGAGE AND EMPOWER MARYLANDERS TO BE STEWARDS OF THEIR OWN HEALTH, WITH THE DESIRED IMPACT OF HEALTHIER COMMUNITIES AND THE REDUCTION OF HEALTH DISPARITIES. 7 7 27 9 0 0 441875 79375 537264 2237075 0 200 893 64793 980032 2381443 0 0 0 0 2396692 1485247 0 0 0 1650574 1985289 4047266 3470536 -3067234 -1089093 2055084 1256950 6234922 6525881 -4179838 -5268931 X TO PROVIDE PATIENT-CENTERED HIGH QUALITY HEALTH AND WELLNESS SERVICES THAT DEEPLY ENGAGE AND EMPOWER MARYLANDERS TO BE STEWARDS OF THEIR OWN HEALTH, WITH THE DESIRED IMPACT OF HEALTHIER COMMUNITIES AND THE REDUCTION OF HEALTH DISPARITIES. 0 0 2141410 2237075 IN THE 2015 TAX YEAR, THE STAFF OF THE ORGANIZATION CONDUCTED THE FOLLOWING CORE ACTIVITIES - PROVISION OF PATIENT CARE, WITH EXTREMELY POSITIVE INITIAL PATIENT FEEDBACK AND CLINICAL OUTCOMES THAT SUGGEST THAT THIS MODEL IS, INDEED, OUTPERFORMING PEER HEALTH CARE PROVIDERS. FOR EXAMPLE, INITIAL DATA SUGGESTS THAT THE ORGANIZATION HAS BEEN ABLE TO REDUCE UNNECESSARY EMERGENCY ROOM (ER) UTILIZATION RELATIVE TO OTHER COMMERCIALLY INSURED INDIVIDUALS - OUTREACH TO COMMUNITIES TO RAISE AWARENESS ABOUT THE NEW OFFERING-COLLABORATION WITH PUBLIC HEALTH OFFICIALS AND OTHER NON-PROFITS TO INFORM PLANS AND LAY THE GROUNDWORK FOR COLLABORATION-CONTRACTING WITH MEDICAID MANAGED CARE ORGANIZATIONS(MCOS) TO PROVIDE MEDICAL CARE TO MEDICAID PARTICIPANTS, INCLUDING THOSE WHO BENEFITED FROM MARYLAND'S EXPANSION OF THE MEDICAID PROGRAM-CONTRACTING WITH THE MARYLAND'S VETERAN'S ADMINISTRATION(VA) TO PROVIDE PRIMARY CARE SERVICES TO VETERANS WHO WOULD OTHERWISE EXPERIENCE LONG WAIT TIMES TO GET AN APPOINTMENT AT A VA FACILITY (BY TAKING ON THESE PATIENTS (AND DOING SO QUICKLY), WE ARE CERTAINLY PROVIDING A PUBLIC SERVICE TO OUR COUNTRY'S VETERANS, THUS RELIEVING FEDERAL BURDEN IN A WAY THAT HAS NO PRIVATE INTEREST AND IS CONSISTENT WITH OUR DESIRE TO SERVE INDIVIDUALS REGARDLESS OF ECONOMIC STRATA OR TYPE OF INSURANCE COVERAGE)-DEVELOPMENT OF PARTNERSHIP WITH THE HOWARD COUNTY LOCAL HEALTH IMPROVEMENT COALITIONS(LHICS) TO IMPROVE ACCESS TO HIGH QUALITY PRIMARY CARE FOR VULNERABLE HOWARD COUNTY RESIDENTS-EXPANSION OF OUR HEALTH COACHING PROGRAM TO INCLUDE FREE CRISIS INTERVENTION SERVICES FOR PATIENTS-ONGOING DEVELOPMENT/EXPANSION OF OUR MENTAL HEALTH SERVICES TO PROVIDE MORE INTENSIVE SERVICES(I.E. PSYCHOTHERAPY) TO PATIENTS WHOSE MENTAL HEALTH NEEDS EXTEND BEYOND THE INITIAL SCOPE OF SERVICES-OUTREACH TO PATIENTS WHO ARE NOT ACTIVELY ACCESSING PRIMARY CARE MEDICAL CARE SERVICES TO ENCOURAGE THEM TO SCHEDULE PREVENTIVE OFFICE VISITS-PARTICIPATION IN A GRANT PROGRAM BY THE HORIZON FOUNDATION THAT ENABLE US TO FUND A HEALTH COACH POSITION. THE HEALTH COACH PROVIDED FREE PREVENTIVE HEALTH COACHING AND BEHAVIORAL HEALTH SUPPORT TO PATIENTS OF THE HOWARD COUNTY-BASED OFFICE-EARLY PLANNING FOR SEVERAL INITIATIVES THAT WILL BE IMPLEMENTED IN 2015/16, INCLUDING BUT NOT LIMITED TO-GROUP HEALTH SUPPORT AND DISEASE EDUCATION ON HEALTH TOPICS SUCH AS SMOKING CESSATION, DIABETES MANAGEMENT, STRESS AND ANXIETY MANAGEMENT, PARENTING-MEDICATION ASSISTANCE PROGRAM TO HELP LOW-INCOME COMMERCIALLY INSURED PATIENTS WITH CHRONIC DISEASES AFFORD MEDICATION WHERE A FINANCIAL BARRIER(E.G.CO-INSURANCE, PRE-DEDUCTIBLE OUT OF POCKET REQUIREMENT) WOULD OTHERWISE PREVENT FILLING OF A PRESCRIPTION-PARTNERSHIP WITH PSYCHIATRISTS TO INCREASE ACCESS TO PSYCHIATRY FOR OUR PATIENTS VIA TELE-CONSULTATION. 2141410 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 0 0 0 0 0 0 0 0 0 1 19 0 27 1 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MD X ELIZABETH MUNFA 4434513873 3000 FALLS ROAD SUITE 1 BALTIMORE MD 21211 PETER L BEILENSON MD MPH DIRECTOR, PRESIDENT, CHAIRMAN 5.00 X X 0 0 0 RICK BARTH PHD DIRECTOR 0.50 X 0 0 0 SETH BENSON DIRECTOR 1.00 X 0 0 0 GAIL DOERR DIRECTOR 0.50 X 0 0 0 NEAL FRIEDLANDER MD DIRECTOR 1.00 X 0 0 0 JIM MCGILL PHD DIRECTOR 1.00 X 0 0 0 WHITNEY REID DIRECTOR 0.50 X 0 0 0 LEN SHERMAN TREASURER, SECRETARY 1.00 X 0 0 0 ROBERT CLARK ESQ GENERAL COUNSEL 0.50 X 0 0 0 ELIZABETH BURGER EXECUTIVE DIRECTOR 2.00 X 108102 0 16000 JOY BALDWIN ASTLE PHYSICIAN 40.00 X 150246 0 16609 MELISSA AVIVA CLARK PHYSICIAN 40.00 X 111964 0 0 370312 0 32609 3 0 1 0 SHR & ASSOCIATES 130 ADMIRAL COCHRANE DRIVE SUITE 1 ANNAPOLIS MD 21401 MANAGEMENT AND BILLING SERVICES 172869 COMPHEALTH PO BOX 972651 DALLAS TX 753972651 PROVIDE DOCTORS WHO WORK AS TEMPORARY EM 108427 2 79375 79375 PATIENT SERVICES 900099 2237075 2237075 2237075 200 200 MICELLANEOUS REVENUE 900099 64793 64793 64793 2381443 2237075 0 64993 X 290957 290957 938842 938842 33001 33001 135481 135481 86966 73921 13045 248303 64751 183552 14628 14628 51950 51950 437681 175500 262181 4408 4408 120 120 514386 514386 6317 6317 4158 4158 211756 211756 107807 107807 80920 77727 3193 LOAN ACQUISITION COSTS 123831 123831 CLINICAL SUPPLIES 112918 112918 HR/PAYROLL 2931 2931 63175 63175 3470536 2141410 1329126 0 699297 90061 200578 104925 23321 33537 64909 157381 42002 890208 221339 764254 668869 43500 295690 123710 2055084 1256950 326197 231783 5908725 6294098 6234922 6525881 X -4432806 -5277056 252968 8125 -4179838 -5268931 2055084 1256950 -1089093 0 X X 0 1 X 1 0 X 75000 441875 79375 596250 537264 2237075 2774339 75000 979139 2316450 3370589 75000 235000 52500 362500 0 75000 235000 52500 362500 3008089 200 200 200 200 893 64793 65686 75000 980032 2381443 3436475 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 447043 92071 354972 74484 19736 54748 368681 109532 259149 668869 DEPOSITS 123710 123710 LINE OF CREDIT 6050000 DEFERRED RENT 196320 DUE TO EVERGREEN HEALTH CARE 47778 6294098 X 2384571 3128 3128 2381443 0 2381443 3473664 3128 3128 3470536 0 3470536 PART X, LINE 2: THE COMPANY IS A NOT-FOR-PROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND IS RECOGNIZED AS SUCH BY THE INTERNAL REVENUE SERVICE. ACCOUNTING PRINCIPLES ACCEPTED IN THE UNITED STATES OF AMERICA PROVIDES CONSISTENT GUIDANCE FOR THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND PRESCRIBE A THRESHOLD OF "MORE LIKELY THAN NOT" FOR RECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE COMPANY PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2015, AND DETERMINED THAT THERE WERE NO MATTERS THAT WOULD REQUIRE RECOGNITION IN THE ACCOMPANYING FINANCIAL STATEMENTS OR WHICH MAY HAVE ANY EFFECT ON ITS TAX-EXEMPT STATUS. AS OF DECEMBER 31, 2015, THE STATUTE OF LIMITATIONS FOR FISCAL YEAR 2013, THE YEAR OF INCEPTION, THROUGH 2015 REMAINS OPEN WITH THE U.S. FEDERAL JURISDICTION AND THE VARIOUS STATES AND LOCAL JURISDICTIONS IN WHICH THE COMPANY FILES TAX RETURNS. IT IS THE COMPANY'S POLICY TO RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IF ANY, IN INCOME TAX EXPENSE. PART XI, LINE 2D - OTHER ADJUSTMENTS: ALLOWANCE FOR BAD DEBT 3,128. PART XII, LINE 2D - OTHER ADJUSTMENTS: ALLOWANCE FOR BAD DEBTS 3,128. X X X 0 0 0 0 0 0 0 0 0 JOY BALDWIN ASTLE PHYSICIAN 150246 0 0 0 0 0 16609 0 0 0 166855 0 0 0 PETER L BEILENSON THE OFFICER LISTED IS ALSO OFFICER OF EVERGREEN HEALTH COOPERATIVE, INC. 253035 YHN AND EVERGREEN HAVE AN ADMINISTRATIVE SERVICES AGREEMENT WHERE EVERGREEN PERFORMS CERTAIN SERVICES ON BEHALF OF YHN. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO CORPORATE MANAGEMENT SUPPORT, ACCOUNTING AND FINANCE, OCCUPANCY, INFORMATION TECHNOLOGY CONSULTING AND SUPPORT, DATA COLLECTION AND REPORTING, HUMAN RESOURCES, AND MARKETING AND LEGAL SERVICES. 0 FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY THE CEO BY THE CEO AND THE COO. THE FORM IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT IF AN INTERESTED PERSON HAS AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE PERSON MUST DISCLOSE THE EXTENSION AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. FORM 990, PART VI, SECTION B, LINE 15A IN 2015, THE COMPENSATION OF THE EXECUTIVE DIRECTOR WAS DETERMINED BY THE INDEPENDENT BOARD OF DIRECTORS. MARKET SURVEYS WERE USED TO DETERMINE REASONABLE COMPENSATION. THE APPROVAL OF THE EMPLOYMENT CONTRACT WAS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTERESTS POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART IX, LINE 11G OTHERE PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 175,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 175,500. LAB : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 90,484. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 90,484. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 171,697. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 171,697. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.