2014-02-05T12:11:57-06:00 2013-06-30 232932984 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2012-07-01 237354899 CHESPENN HEALTH SERVICES INC CHES 6104853800 2600 WEST 9TH STREET 2 NORTH CHESTER PA 19013 MICHAEL G LUCAS 6104853800 2014-02-04 1 JULIUS GREEN CPA P00350393 2159720701 2012 2015-11-30 17:44:51Z MICHAEL G LUCAS 2600 WEST 9TH STREET 2 NORTH CHESTER PA 19013 8001985 0 X WWW.CHESPENN.COM X 1973 PA CHESPENN HEALTH SERVICES OPERATES FOUR COMPREHENSIVE HEALTH CENTERS LOCATED IN PENNSYLVANIA. 16 16 122 16 0 0 3107772 2753950 5625571 5242581 9377 5454 0 0 8742720 8001985 0 0 0 0 5174751 5607972 0 0 14789 3561137 3713345 8735888 9321317 6832 -1319332 6124350 5381904 777392 1354278 5346958 4027626 X CHESPENN HEALTH SERVICES IS A NETWORK OF NON-PROFIT, FEDERALLY QUALIFIED HEALTH CENTERS THAT PROVIDES COMPREHENSIVE PRIMARY AND PREVENTIVE HEALTH CARE AND SOCIAL SERVICES TO MEDICALLY UNDERSERVED FAMILIES AND INDIVIDUALS ON A SLIDING SCALE. CHESPENN HEALTH SERVICES STRIVES TO MEET THE UNIQUE HEALTH NEEDS IN ITS COMMUNITIES IN LINGUISTICALLY AND CULTURALLY COMPETENT WAYS. 0 0 7481290 5242581 SINCE 1973, CHESPENN HEALTH SERVICES HAS PROVIDED COMPREHENSIVE FAMILY MEDICAL AND DENTAL CARE TO THE RESIDENTS OF CHESTER, PA AND NEIGHBORING COMMUNITIES. IN 2005, CHESPENN EXPANDED THESE HEALTH CARE SERVICES TO THE COATESVILLE AREA, AND IN 2009, CHESPENN OPENED THE CENTER FOR FAMILY HEALTH IN UPPER DARBY, PA. ADDITIONAL SERVICES THAT ARE OFFERED INCLUDE HOMELESS HEALTH CARE, FAMILY PLANNING SERVICES, OB/GYN, HIV/AIDS CARE AND AN IN-HOUSE PHYSICIAN DISPENSARY. CHESPENN IS PRINCIPALLY FUNDED BY GRANTS FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. DURING THE 2012 TAX YEAR, CHESPENN RECEIVED TOTAL GRANT REVENUE OF $1,727,706.DURING THE 2012 TAX YEAR, CHESPENN HAD TOTAL ENCOUNTERS OF 46,480, OF WHICH 41,685 WERE BILLABLE. THE BILLABLE ENCOUNTERS CONSISTED OF THE FOLLOWING IN CHESTER, PA: 9,758 PEDIATRIC ENCOUNTERS, 8,886 ADULT ENCOUNTERS, AND 7,493 DENTAL ENCOUNTERS. IN ADDITION, THERE WERE 8,226 ENCOUNTERS AT THE UPPER DARBY CENTER FOR FAMILY HEALTH AND 7,322 ENCOUNTERS IN THE COATESVILLE SERVICE AREA. NON BILLABLE ENCOUNTERS CONSISTED OF 4,795 NURSE ONLY VISITS.CHESPENN PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE AMOUNTS DETERMINED TO BE CHARITY CARE ARE NOT REPORTED AS REVENUES. DURING THE 2012 TAX YEAR, CHESPENN PROVIDED CHARITY CARE OF APPROXIMATELY $1,008,724 TO PATIENTS. 7481290 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 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 0 0 0 0 1 16 0 1 122 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 PA X DANIEL A CAPLAN 6104853800 2600 WEST 9TH STREET 2 NORTH CHESTER PA 19013 WILLIE MAE WELLS 1.00 X X 0 0 0 RAE ROEDER 1.00 X X 0 0 0 JOAN RICHARDS 1.00 X X 0 0 0 SHANA M HIGGS 1.00 X 0 0 0 CHRISTINE DONAHUE HENRY 1.00 X 0 0 0 ABU RAHMAN 1.00 X 0 0 0 KAREN VESELY 1.00 X 0 0 0 ANTHONY HALL 1.00 X 0 0 0 DONNA LAWLER 1.00 X 0 0 0 CAROL ALLEN 1.00 X 0 0 0 ELAINE GREENE-UPTON 1.00 X 0 0 0 DAVID KEITH 1.00 X 0 0 0 CATHERINE CARR 1.00 X 0 0 0 JEFFREY GREEN 1.00 X 0 0 0 GWEN SMITH 1.00 X 0 0 0 LAVADA DRIGGINS 1.00 X 0 0 0 MICHAEL LUCAS 40.00 X 201635 0 23072 REKHA YAGNIK MD 40.00 X 204691 0 16022 SALUD TIRO MD 32.00 X 129596 0 12557 RAQUIBUL ISLAM MD 40.00 X 139240 0 12899 KEVIN MCCABE MD 40.00 X 132058 0 7575 MICHAEL KANE 40.00 X 121418 0 7081 928638 0 79206 8 0 1 0 COORDINATED CARE NETWORK 300 PENN CENTER BLVD PITTSBURGH PA 15235 CONTRACTED PHARMACY SERVICES 615780 HEALTH ACCESS NETWORK ONE MEDICAL CENTER BLVD UPLAND PA 19013 CONTRACTED PHYSICIAN SERVICES 519375 CROZER-KEYSTONE HEALTH SYSTEM 100 WEST SPROUL RD PAVILION II MANAGEMENT FINANCIAL PA 19064 MANAGEMENT & FINANCIAL SERVICES AGREEMEN 206565 GE HEALTHCARE IITS USA CORP 15724 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 INFORMATION TECHNOLOGY SERVICES 134829 4 69669 2028280 656001 2753950 NET PATIENT SERVICE RE 621400 5242581 5242581 5242581 5454 5454 8001985 5242581 0 5454 235932 235932 4035423 3470765 552268 12390 546349 135685 410203 461 459599 372158 85844 1597 330669 309267 21061 341 58520 3384 55136 52575 7144 45431 928954 871109 57845 7341 539 6802 294405 234910 59495 236250 6175 230075 797609 704189 93420 74319 25945 48374 334800 238123 96677 19111 13014 6097 PATIENT CARE 741742 737688 4054 PROVISION FOR DOUBTFUL 101694 101694 DUES AND SUBSCRIPTIONS 43938 2595 41343 SERVICE CHARGES 9505 1337 8168 12582 9637 2945 9321317 7481290 1825238 14789 39778 26987 2853995 2517495 235663 188201 283807 289413 46518 34892 56272 49740 4358883 2359927 2221508 1998956 386809 276220 6124350 5381904 714892 1219278 62500 135000 777392 1354278 X 5346958 4027626 5346958 4027626 6124350 5381904 -1319332 0 X 0 1 X 1 1 1 X 2247223 2856071 3487000 3107773 2753950 14452017 5303293 5798455 5955200 5625571 5242581 27925100 7550516 8654526 9442200 8733344 7996531 42377117 0 0 0 42377117 18067 22736 16729 9377 5454 72363 18067 22736 16729 9377 5454 72363 7568583 8677262 9458929 8742721 8001985 42449480 0.99830 0.99350 0.00170 0.00210 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 100838 100838 2663637 1233079 1430558 349794 138060 211734 1196143 948027 248116 48471 40761 7710 1998956 SECURITY DEPOSITS 579 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 275641 276220 X 8001985 0 8001985 0 8001985 9321317 0 9321317 0 9321317 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2013 AND 2012. THE CORPORATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN SUPPLIES AND EXPENSES. THE CORPORATION DOES NOT PERFORM ANY ACTIVITIES THAT WOULD BE SUBJECT TO UNRELATED BUSINESS INCOME TAX; THEREFORE, IT HAS NOT FILED FORM 990-T, EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN. X X X 0 0 0 0 0 0 0 0 0 MICHAEL LUCAS 176466 0 25169 0 0 0 10082 0 12990 0 224707 0 0 0 REKHA YAGNIK MD 204691 0 0 0 0 0 10235 0 5787 0 220713 0 0 0 RAQUIBUL ISLAM MD 136240 0 3000 0 0 0 6962 0 5937 0 152139 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 CROZER KEYSTONE HEALTH SYSTEM PROVIDES FISCAL, LEGAL AND HEALTH SERVICES VIA THE MANAGEMENT CONSULTING AND ADMINISTRATIVE AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11 THE FINAL 990 RETURN WAS PRESENTED AND APPROVED BY THE FINANCE COMMITTEE ALONG WITH THE BOARD OF DIRECTORS OF CHESPENN HEALTH SERVICES. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS MUST ANNUALLY SIGN THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS ARE ALSO REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST THAT MAY ARISE DURING THE YEAR AND MUST REFRAIN FROM DISCUSSING, AS WELL AS VOTING ON, SUCH MATTERS THAT PERTAIN TO THE CONFLICT. EMPLOYEES OF THE ORGANIZATION ARE ALSO REQUIRED TO REPORT ANY POTENTIAL OR ACTUAL CONFLICT TO THE EXECUTIVE DIRECTOR. THE PRESIDENT/CEO IS RESPONSIBLE FOR MONITORING AND RESOLVING ANY CONFLICT OF INTEREST THAT MAY ARISE WITHIN THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 TO DETERMINE SALARIES OF OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, CHESPENN UTILIZES THE ANNUAL COMPENSATION SURVEY CONDUCTED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. THIS COMPENSATION REVIEW IS PERFORMED ANNUALLY TO ASSURE MARKET COMPATIBILITY WITH OTHER HEALTH CENTERS IN THE REGION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 13: THE ORGANIZATION IS CURRENTLY DEVELOPING A WHISTLEBLOWER POLICY WHICH IS EXPECTED TO BE APPROVED BY THE BOARD IN 2014. FORM 990, PART VI, SECTION 1, LINE 1A: THE EXECUTIVE COMMITTEE SHALL BE A COMMITTEE OF THE BOARD AND SHALL PERFORM THE FUNCTIONS OF THE BOARD OF DIRECTORS OF THE CORPORATION IN THE MANAGEMENT OF THE AFFAIRS OF THE CORPORATION DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. ANY ACTION TAKEN BY THE EXECUTIVE COMMITTEE SHALL BE REPORTED AT THE NEXT REGULAR MEETING OF THE BOARD OF DIRECTORS.