2014-06-12T14:47:25-05:00 2013-12-31 420714325 MCGLADREY LLP 1185 AVENUE OF THE AMERICAS NEW YORK NY 100362602 990 2013-01-01 132813103 OPEN DOOR FAMILY MEDICAL CENTER INC OPEN 9145021470 165 MAIN STREET OSSINING NY 10562 LINDSAY C FARRELL PRESIDENT & CEO 9145021470 2014-06-12 1 MARTIN GREIF P00029738 2123721000 2013 2015-11-30 17:44:51Z LINDSAY C FARRELL 165 MAIN STREET OSSINING NY 10562 83917853 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. 18 18 430 313 0 0 10018576 9589529 25286649 24787294 247475 28860318 415562 404724 35968262 63641865 0 0 0 0 20397432 21947419 0 0 0 9466603 10078363 29864035 32025782 6104227 31616083 46340182 81156047 9757625 7748917 36582557 73407130 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 20332322 18967609 OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 35,202 MEDICAL PATIENTS THAT GENERATED 139,464 VISITS IN 2013. 3737879 4743061 OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 14,268 DENTAL PATIENTS THAT GENERATED 32,717 VISITS IN 2013. 1675562 1076624 OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 2,051 MENTAL HEALTH PATIENTS THAT GENERATED 9,035 VISITS IN 2013. 25745763 1 1 0 0 0 0 0 0 0 0 1 0 0 1 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 26 0 1 430 1 0 0 0 0 0 0 0 0 0 0 X 18 18 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 CHARLES CHEHEBAR BOARD MEMBER 1.00 0.10 X 0 0 0 JOHN CONYERS BOARD MEMBER 1.00 0.10 X 0 0 0 WALTER EDGE BOARD MEMBER 1.00 0.10 X 0 0 0 JENNIFER GURAHIAN 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 FROM 513 BOARD MEMBER 1.00 0.10 X 0 0 0 KEVIN NELSON THRU 513 BOARD MEMBER 1.00 0.10 X 0 0 0 MARIA M PEREZ THRU 513 BOARD MEMBER 1.00 0.10 X 0 0 0 JULIE PESKOE FROM 513 BOARD MEMBER 1.00 0.10 X 0 0 0 MARGOTH PILLA BOARD MEMBER 1.00 0.10 X 0 0 0 ROSA ROJAS THRU 513 BOARD MEMBER 1.00 0.10 X 0 0 0 DIANA SCHAEFER VICE CHAIRMAN 1.00 0.10 X X 0 0 0 HOWARD S SCHRADER BOARD MEMBER 1.00 0.10 X 0 0 0 ELIZABETH SHARPE FROM 513 BOARD MEMBER 1.00 0.10 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 ROSA TAYLOR THRU 513 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 SECRETARY 1.00 0.10 X X 0 0 0 LINDSAY C FARRELL PRESIDENT & CEO 34.00 4.00 X 275872 12609 16838 MARIA MAZZOTTA CHIEF FINANCIAL OFFICER 34.00 4.00 X 188484 9224 2670 ANITA WILENKIN CHIEF OPERATING OFFICER 38.00 X 181357 0 26916 DAREN WU CHIEF MEDICAL OFFICER 38.00 X 325173 0 12510 JANET H BOZZONE DIRECTOR OF DENTAL SERVICES 38.00 X 213177 0 12282 KAREN MURRAY DIRECTOR OF OB/GYN SERVICES 38.00 X 216751 0 22782 BRUCE M SHAFFER PODIATRIST 38.00 X 227825 0 25198 THOMAS YUEN FAMILY PRACTICE PHYSICIAN 38.00 X 198809 0 31324 JOSE JUAN VICENS-VILLAFANA OB/GYN PHYSICIAN 38.00 X 203122 0 7249 DEBRA L GERSON FAMILY PRACTICE PHYSICIAN 38.00 X 193365 0 10320 ASAF COHEN FAMILY PRACTICE PHYSICIAN 38.00 X 186574 0 14115 2410509 21833 182204 46 0 1 0 COMPREHENSIVE EYE SERVICES PO BOX 187 ARMONK NY 10504 EYE CLINIC 288319 ECLINICAL WORKS TWO TECHNOLOGY DRIVE WESTBOROUGH MA 01581 ECW SUPPORT & E-SUBSCRIBING 137962 MEDPARTNERS LOCUMS TENENS INC P O BOX 4729 WINTER PARK FL 327934729 LOCUM TENENS 129846 MCGLADREYLLP 1185 AVENUE OF THE AMERICAS NEW YORK NY 10036 AUDIT/TAX PREPARATION 115754 WESTCHESTER INSTITUTE OF HUMAN DEVELOPME CEDAR HALL RM322 VALHALLA NY 10595 PROJECT LAUNCH EVALUATOR 104908 5 X 7963228 1626301 9589529 MEDICAID 621400 14159511 14159511 UNCOMPENSATED CARE 621400 4256054 4256054 SELF-PAY 621400 2650545 2650545 CHILD HEALTH PLUS 621400 2323625 2323625 MEDICARE 621400 740594 740594 656965 656965 24787294 349896 349896 20553902 28232508 20275988 0 277914 28232508 28510422 28510422 REIMB SALARIES & FRINGE 900099 358167 358167 MISC. REVENUE 900099 46557 46557 404724 63641865 24787294 0 29265042 1473838 1282522 191316 16727814 14386706 2341108 798624 684689 113935 1437126 1236285 200841 1510017 1310603 199414 153263 153263 175836 175836 159940 159940 2225089 1338990 886099 6185 6185 2000013 1703600 296413 941025 935144 5881 50394 38056 12338 222009 112567 109442 244766 244766 1161579 532094 629485 253455 131609 121846 PHARMACEUTICALS 649958 649958 LABORATORY FEES 416028 416028 REPAIRS & MAINTENANCE 363489 279262 84227 MISCELLANEOUS EXPENSES 312971 260285 52686 742363 441180 301183 32025782 25745763 6280019 0 6987689 6207183 2700670 9468188 1595925 1255803 4014842 1926147 677995 336968 27650186 13993947 13799941 13656239 15981092 41451960 582028 6853559 46340182 81156047 6261793 4559711 50000 3450401 3139206 45431 0 9757625 7748917 X 36549724 73380464 32833 26666 36582557 73407130 46340182 81156047 X 31616083 3446826 1761664 X 0 1 X 1 1 1 X 6890084 8526604 10756507 10018576 9589529 45781300 6890084 8526604 10756507 10018576 9589529 45781300 45781300 48675 153335 201594 264381 348896 1016881 5676 338569 377091 415562 404724 1541622 48339803 138775981 0.94710 0.95730 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1740016 1740016 2274217 1427584 846633 13758779 7124038 6634741 3811871 3110123 701748 6065303 2332202 3733101 13656239 SECURITY DEPOSITS 28860 DEBT SERVICE RESERVE FUND 555778 DUE FROM AFFILIATED ENTITIES 268921 MEMBERSHIP CHANGE AGREEMENT RECEIVABLE 6000000 6853559 X 70534655 3446826 300820 3503311 7250957 63283698 358167 358167 63641865 32653162 300820 326560 627380 32025782 0 32025782 PART X, LINE 2: THE CENTER WAS INCORPORATED AS A NOT-FOR-PROFIT CORPORATION UNDER THE LAWS 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 2010, WHICH IS THE STANDARD STATUTE OF LIMITATIONS LOOK-BACK PERIOD. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE OF RELATED ENTITIES 1,741,647. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 1,761,664. PART XI, LINE 4B - OTHER ADJUSTMENTS: REIMBURSED SALARIES/FRINGE 358,167. PART XII, LINE 2D - OTHER ADJUSTMENTS: REIMBURSED SALARIES/FRINGE -358,167. EXPENSES OF RELATED ENTITIES 684,727. X 1 1 X X X 0 0 0 0 0 1 0 1 0 LINDSAY C FARRELL PRESIDENT & CEO 244696 12609 30000 0 1176 0 10150 0 6688 0 292710 12609 0 0 MARIA MAZZOTTA CHIEF FINANCIAL OFFICER 180771 9224 7500 0 213 0 0 0 2670 0 191154 9224 0 0 ANITA WILENKIN CHIEF OPERATING OFFICER 172767 0 7500 0 1090 0 6659 0 20257 0 208273 0 0 0 DAREN WU CHIEF MEDICAL OFFICER 259319 0 45036 0 20818 0 10375 0 2135 0 337683 0 0 0 JANET H BOZZONE DIRECTOR OF DENTAL SERVICES 184640 0 27768 0 769 0 7471 0 4811 0 225459 0 0 0 KAREN MURRAY DIRECTOR OF OB/GYN SERVICES 216558 0 0 0 193 0 7814 0 14968 0 239533 0 0 0 BRUCE M SHAFFER PODIATRIST 227007 0 0 0 818 0 8255 0 16943 0 253023 0 0 0 THOMAS YUEN FAMILY PRACTICE PHYSICIAN 165672 0 33005 0 132 0 7364 0 23960 0 230133 0 0 0 JOSE JUAN VICENS-VILLAFANA OB/GYN PHYSICIAN 202997 0 0 0 125 0 2153 0 5096 0 210371 0 0 0 DEBRA L GERSON FAMILY PRACTICE PHYSICIAN 193010 0 0 0 355 0 6774 0 3546 0 203685 0 0 0 ASAF COHEN FAMILY PRACTICE PHYSICIAN 155397 0 31064 0 113 0 6701 0 7414 0 200689 0 0 0 PART I, LINE 1A DAREN WU, CHIEF MEDICAL OFFICER, RECEIVED A $20,000 TAXABLE HOUSING ALLOWANCE. 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 12/31/13: DAREN WU, CHIEF MEDICAL OFFICER - $39,036 JANET H. BOZZONE, DIRECTOR OF DENTAL SERVICES - $23,768 THOMAS YUEN, FAMILY PRACTICE PHYSICIAN - $33,005 ASAF COHEN, FAMILY PRACTICE PHYSICIAN - $31,064 PART I, LINE 7 THE FOLLOWING INDIVIDUALS, LISTED ON PART VII, RECEIVED NON-FIXED PAYMENTS, DETERMINED BY THE BOARD, DURING THE YEAR ENDED 12/31/13: LINDSAY C. FARRELL - $30,000 MARIA MAZZOTTA - $7,500 DAREN WU - $6,000 JANET BOZZONE - $4,000 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 MAY 2014, THE FORM 990, FOR THE YEAR ENDED DECEMBER 31, 2013, 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; 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 VIII, LINE 7C(II) THE AMOUNT OF $28,232,508 WAS REALIZED FROM THE DISPOSITION OF AN INTEREST IN HUDSON HEALTH PLAN, INC. DUE TO REQUIRED RESTRUCTURING UNDER THE ACA OF 2010. FORM 990, PART XI, LINE 9: PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 1,761,664. 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 366816 20100 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 332258 COST