2015-07-31T10:46:43-05:00 2014-12-31 420714325 MCGLADREY LLP 1185 AVENUE OF THE AMERICAS NEW YORK NY 100362602 990 2014-01-01 132813103 OPEN DOOR FAMILY MEDICAL CENTER INC OPEN 9145021470 165 MAIN STREET OSSINING NY 10562 LINDSAY C FARRELL PRESIDENT & CEO 9145021470 2015-07-31 1 MARTIN GREIF P00029738 2123721000 2014 2016-02-25 16:41:14Z LINDSAY C FARRELL 165 MAIN STREET OSSINING NY 10562 55080714 0 X WWW.OPENDOORMEDICAL.ORG X 1975 NY OPEN DOOR FAMILY MEDICAL CENTER PROVIDES QUALITY PRIMARY HEALTH CARE AND HUMAN SERVICES AT AFFORDABLE PRICES TO THE COMMUNITY, PARTICULARLY LOW-INCOME, UNDER-SERVED RESIDENTS AND THOSE LACKING ACCESS TO HEALTH CARE. 20 20 484 134 0 0 9589529 10087522 24787294 28991462 28860318 3885354 404724 301875 63641865 43266213 0 0 0 0 21947419 23873386 0 0 274086 10078363 12000673 32025782 35874059 31616083 7392154 81156047 89772968 7748917 8840831 73407130 80932137 THE MISSION OF THE OPEN DOOR FAMILY MEDICAL CENTER, INC. IS TO PROVIDE QUALITY PRIMARY HEALTH CARE AND HUMAN SERVICES AT AFFORDABLE PRICES TO THE COMMUNITY, PARTICULARLY LOW-INCOME, UNDER-SERVED RESIDENTS AND THOSE LACKING ACCESS TO HEALTH CARE. 0 0 22982658 22508345 OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 37,497 MEDICAL PATIENTS THAT GENERATED 150,759 VISITS IN 2014. 4008615 5233483 OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 15,363 DENTAL PATIENTS THAT GENERATED 35,739 VISITS IN 2014. 1689254 1249634 OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 7,263 MENTAL HEALTH PATIENTS THAT GENERATED 15,604 VISITS IN 2014. 28680527 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 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 1 1 1 0 0 1 17 0 1 484 1 0 0 0 0 0 0 0 0 0 0 X 20 20 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MARIA MAZZOTTA 9145021470 165 MAIN STREET OSSINING NY 10562 X TYLER BEEBE BOARD MEMBER 1.00 0.10 X 0 0 0 SHIRLEY BUONTEMPO FROM 514 BOARD MEMBER 1.00 0.10 X 0 0 0 CHARLES CHEHEBAR BOARD MEMBER 1.00 0.10 X 0 0 0 JOHN CONYERS BOARD MEMBER 1.00 0.10 X 0 0 0 CARMEN TAVERAS-CRUZ FROM 514 BOARD MEMBER 1.00 0.10 X 0 0 0 WALTER EDGE BOARD MEMBER 1.00 0.10 X 0 0 0 JENNIFER GURAHIAN THRU 514 BOARD MEMBER 1.00 0.10 X 0 0 0 DORIAN LINDSAY BOARD MEMBER 1.00 0.10 X 0 0 0 ANTONIO MEJIAS BOARD MEMBER 1.00 0.10 X 0 0 0 LORETTA MOLINARI BOARD MEMBER 1.00 0.10 X 0 0 0 PATRICIA PEREZ FROM 514 BOARD MEMBER 1.00 0.10 X 0 0 0 JULIE PESKOE BOARD MEMBER 1.00 0.10 X 0 0 0 MARGOTH PILLA BOARD MEMBER 1.00 0.10 X 0 0 0 DIANA SCHAEFER VICE CHAIRPERSON 1.00 0.10 X X 0 0 0 HOWARD S SCHRADER BOARD MEMBER 1.00 0.10 X 0 0 0 ELIZABETH SHARPE SECRETARY 1.00 0.10 X X 0 0 0 DAVID K SHERMAN TREASURER 1.00 0.10 X X 0 0 0 STEWART TABIN BOARD MEMBER 1.00 0.10 X 0 0 0 ANDRES VALDESPINO CHAIRMAN 1.00 0.10 X X 0 0 0 LUIS VICETTI BOARD MEMBER 1.00 0.10 X 0 0 0 DONNA WADE BOARD MEMBER 1.00 0.10 X 0 0 0 LINDSAY C FARRELL PRESIDENT & CEO 36.00 2.00 X 284811 14990 18160 MARIA MAZZOTTA CHIEF FINANCE OFFICER 36.00 2.00 X 201941 10629 9156 ANITA WILENKIN CHIEF OPERATING OFFICER 38.00 0.00 X 205625 0 30522 DAREN WU CHIEF MEDICAL OFFICER 38.00 0.00 X 384689 0 12813 JANET BOZZONE DIRECTOR OF DENTAL SERVICES 38.00 0.00 X 222407 0 12599 KAREN MURRAY OB/GYN PHYSICIAN 38.00 0.00 X 239852 0 29219 THOMAS YUEN FAMILY PRACTICE PHYSICIAN 38.00 0.00 X 278462 0 36587 JAY ABRAM ZASLOW FAMILY PRACTICE PHYSICIAN 38.00 0.00 X 235413 0 34092 BRUCE M SHAFFER PODIATRIST 38.00 0.00 X 237725 0 27214 JOSE JUAN VICENS-VILLAFANA OB/GYN PHYSICIAN 38.00 0.00 X 226019 0 13085 2516944 25619 223447 50 0 1 0 HITCH INC 2 CHURCH STREET SUITE 110 OSSINING NY 10562 CSP SERVICES 519576 COMPREHENSIVE EYE SERVICES PO BOX 187 ARMONK NY 10504 EYE CLINIC 350159 KARP RESOURCES PO BOX 515 SOUTHOLD NY 11971 HR CONSULTING SERVICES 230553 ECLINICAL WORKS 112 TURNPIKE ROAD SUITE 200 WESTBOROUGH MA 01581 ECW SUPPORT & E-SUBSCRIBING 188871 WELLSPRING CONSULTING LLC 198 AMITY ROAD SUITE 23 WOODBRIDGE CT 06525 STRATEGIC PLANNING PROJECT 179300 10 8753771 1333751 10087522 MEDICAID 621400 16916872 16916872 UNCOMPENSATED CARE 621400 5547785 5547785 SELF-PAY 621400 2677092 2677092 CHILD HEALTH PLUS 621400 2223933 2223933 PRIVATE INSURANCE 621400 815605 815605 810175 810175 28991462 902137 902137 12327379 2470339 11814501 0 512878 2470339 2983217 2983217 REIMB SALARIES & FRINGE 900099 274086 274086 MISCELLANEOUS REVENUE 900099 27789 27789 301875 43266213 28991462 0 4187229 X 1650426 1369767 280659 18243325 15021096 2999476 222753 525728 435756 89284 688 1850599 1524217 312305 14077 1603308 1314208 252532 36568 76456 76456 153225 153225 346951 346951 3745851 2335344 1410507 11313 11313 1989355 1640171 349184 326624 185075 141549 1020807 946896 73911 49171 37369 11802 197024 157510 39514 220792 211960 8832 1257115 1055977 201138 273871 262916 10955 PHARMACEUTICALS 635255 635255 REPAIRS & MAINTENANCE 445726 374410 71316 LABORATORY FEES 433713 433713 MISCELLANEOUS EXPENSES 325003 273377 51626 492421 465510 26911 35874059 28680527 6919446 274086 6207183 4039375 9468188 7977864 1255803 1232546 1926147 3383281 336968 373182 30146223 15254092 13656239 14892131 41451960 54169490 6853559 3705099 81156047 89772968 4559711 5839535 50000 197075 3139206 2804221 7748917 8840831 X 73380464 80892988 26666 39149 73407130 80932137 81156047 89772968 X 7392154 1853297 -1720444 X 0 1 X 1 1 1 X 8526604 10756507 10018576 9589529 10087522 48978738 8526604 10756507 10018576 9589529 10087522 48978738 48978738 153335 201594 264381 348896 902137 1870343 338569 377091 415562 404724 301875 1837821 52686902 147092353 0.92960 0.94710 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1740016 1740016 2274217 1474548 799669 13862541 7815034 6047507 4573130 3410382 1162748 7696319 2554128 5142191 14892131 X 46182330 1853297 294208 1389649 3537154 42645176 346951 274086 621037 43266213 38318392 294208 2497076 2791284 35527108 346951 346951 35874059 PART X, LINE 2: THE CENTER WAS INCORPORATED AS NOT-FOR-PROFIT CORPORATION UNDER THE LAW OF THE STATE OF NEW YORK AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). THEREFORE, THERE IS NO PROVISION FOR INCOME TAXES ON THIS ENTITY. IN ADDITION, THE CENTER IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. MANAGEMENT EVALUATED THE CENTER'S TAX POSITIONS AND CONCLUDED THAT THE CENTER HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. WITH FEW EXCEPTIONS, THE CENTER IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2011, WHICH IS THE STANDARD STATUTE OF LIMITATIONS LOOK-BACK PERIOD. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE OF RELATED ENTITIES 1,389,649. PART XI, LINE 4B - OTHER ADJUSTMENTS: REIMBURSED SALARIES/FRINGE 274,086. PART XII, LINE 2D - OTHER ADJUSTMENTS: REIMBURSED SALARIES/FRINGE -274,086. EXPENSES OF RELATED ENTITIES 1,050,718. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 1,720,444. X X X 0 0 0 0 0 1 0 1 0 LINDSAY C FARRELL PRESIDENT & CEO 255134 13428 28500 1500 1177 62 9975 525 7277 383 302063 15898 0 0 MARIA MAZZOTTA CHIEF FINANCE OFFICER 192318 10122 9358 493 265 14 6161 324 2537 134 210639 11087 0 0 ANITA WILENKIN CHIEF OPERATING OFFICER 196908 0 7486 0 1231 0 7458 0 23064 0 236147 0 0 0 DAREN WU CHIEF MEDICAL OFFICER 317553 0 61648 0 5488 0 10672 0 2141 0 397502 0 0 0 JANET BOZZONE DIRECTOR OF DENTAL SERVICES 189395 0 31699 0 1313 0 7806 0 4793 0 235006 0 0 0 KAREN MURRAY OB/GYN PHYSICIAN 239510 0 0 0 342 0 8723 0 20496 0 269071 0 0 0 THOMAS YUEN FAMILY PRACTICE PHYSICIAN 211525 0 56460 0 10477 0 10122 0 26465 0 315049 0 0 0 JAY ABRAM ZASLOW FAMILY PRACTICE PHYSICIAN 235078 0 0 0 335 0 8578 0 25514 0 269505 0 0 0 BRUCE M SHAFFER PODIATRIST 236766 0 0 0 959 0 8572 0 18642 0 264939 0 0 0 JOSE JUAN VICENS-VILLAFANA OB/GYN PHYSICIAN 225856 0 0 0 163 0 4682 0 8403 0 239104 0 0 0 PART I, LINE 6 THE FOLLOWING INDIVIDUALS, LISTED ON PART VII, RECEIVED INCENTIVE BONUSES, WHICH ARE BASED ON THE NET EARNINGS OF EACH INDIVIDUAL'S BUSINESS SEGMENT, DURING THE YEAR ENDED 12/31/14: DAREN WU, CHIEF MEDICAL OFFICER - $54,328 JANET H. BOZZONE, DIRECTOR OF DENTAL SERVICES - $22,534 THOMAS YUEN, FAMILY PRACTICE PHYSICIAN - $56,460 PART I, LINE 7 THE FOLLOWING INDIVIDUALS, LISTED ON PART VII, RECEIVED NON-FIXED PAYMENTS, DETERMINED BY THE BOARD, DURING THE YEAR ENDED 12/31/14: LINDSAY C. FARRELL - $30,000 MARIA MAZZOTTA - $9,850 DAREN WU - $7,320 JANET BOZZONE - $9,165 FORM 990, PART VI, SECTION A, LINE 6 OPEN DOOR, INC. IS THE SOLE MEMBER OF OPEN DOOR FAMILY MEDICAL CENTER, INC. FORM 990, PART VI, SECTION B, LINE 11 OPEN DOOR FAMILY MEDICAL CENTER ENGAGES THE SERVICES OF AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE ANNUAL FORM 990 IN CONJUNCTION WITH ITS ANNUAL AUDITED FINANCIAL STATEMENTS. THE PRESIDENT/CEO AND CFO REVIEW THE FORM 990 AND SCHEDULES FOR ACCURACY. IN 2015, THE FORM 990, FOR THE YEAR ENDED DECEMBER 31, 2014, WAS PRESENTED TO THE FINANCE COMMITTEE AND BOARD MEMBERS FOR REVIEW PRIOR TO ITS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, ALL THE BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. ALL DISCLOSURE STATEMENTS ARE UPDATED AND REVIEWED ANNUALLY FOR EXISTING OR POTENTIAL CONFLICTS BY THE PRESIDENT/CEO. IF A CONFLICT IS FOUND, THE AFFECTED INDIVIDUAL IS REQUIRED TO RECUSE HIMSELF/HERSELF FROM ANY DECISION MAKING AND VOTING RELATING TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD CONDUCTS PARITY STUDIES TO EVALUATE EXECUTIVE COMPENSATION. THE ENTIRE BOARD GOES INTO EXECUTIVE SESSION TO EVALUATE THE CEO AND DETERMINE COMPENSATION. THE CEO CONDUCTS PARITY STUDIES TO EVALUATE OFFICERS' AND KEY EMPLOYEES' SALARIES FOR THE EXECUTIVE COMMITTEE. THESE SALARIES, AND THE SALARIES OF THE ENTIRE ORGANIZATION, ARE PRESENTED TO THE BOARD FOR APPROVAL DURING THE BUDGET APPROVAL PROCESS TOWARD YEAR-END. THERE IS CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION DELIBERATION AND DECISION IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 OPEN DOOR DOES MAKE ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC BY POSTING ON THE ORGANIZATION'S WEBSITE; PROVIDING COPIES UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D); AND INSPECTION AT AN OFFICE OF THE ORGANIZATION. THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST, AT THE ORGANIZATION'S LOCATION. FORM 990, PART VII THE ORGANIZATION, IN A FULL TRANSPARENCY POSTURE TO REPORTING, IS REPORTING ALL BENEFITS IN FULL IN PART VII, COLUMN F AND NOT APPLYING THE $10,000 PER ITEM EXCEPTION FOR CERTAIN BENEFITS. FORM 990, PART IX, LINE 11G HEALTHCARE CONSULTANTS: PROGRAM SERVICE EXPENSES 1,210,471. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,210,471. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,124,873. MANAGEMENT AND GENERAL EXPENSES 1,410,507. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,535,380. FORM 990, PART XI, LINE 9: PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -1,720,444. FORM 990, PART VIII, LINE 7C(II) THE AMOUNT OF $2,470,339 WAS REALIZED FROM THE DISPOSITION OF AN INTEREST IN HUDSON HEALTH PLAN, INC. DUE TO REQUIRED RESTRUCTURING UNDER THE ACA OF 2010. OPEN DOOR FOUNDATION INC 165 MAIN STREET OSSINING NY 10562 133598184 FUNDRAISING/DEVELOPMENT NY 501(C)(3) LINE 7 OPEN DOOR INC 0 OPEN DOOR INC 165 MAIN STREET OSSINING NY 10562 133585009 SUPPORTING ORGANIZATION NY 501(C)(3) LINE 11A, I 0 OPEN DOOR LEASING CORP 165 MAIN STREET OSSINING NY 10562 201726717 LEASING SPACE NY OPEN DOOR FAMILY MEDICAL CENTER INC C 465760 27496 1.00000 1 0 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 1 0 0 OPEN DOOR LEASING CORP K 397457 COST