2014-08-07T16:22:49-05:00 2013-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL SUITE 201 PITTSFORD NY 14534 990 2013-01-01 160977295 ANTHONY L JORDAN HEALTH CORPORATION ANTH 5854235800 82 HOLLAND STREET ROCHESTER NY 14605 DR JANICE HARBIN DDS CEO 5854235800 2014-08-07 1 CRAIG M STEVENS P00748583 5853811000 2013 2015-11-30 17:44:51Z DR JANICE HARBIN DDS 82 HOLLAND STREET ROCHESTER NY 14605 29214597 0 X WWW.JORDANHEALTH.ORG X 1968 NY THE CENTER IS DEDICATED TO PROVIDING HIGH-QUALITY PRIMARY AND PREVENTIVE HEALTHCARE, WITH A MAJOR FOCUS ON HEALTH EDUCATION/WELLNESS PROMOTION, AND THE REQUIREMENT TO MEET OR EXCEED PATIENT/CUSTOMER EXPECTATIONS. AS A TRENDSETTER IN THE DELIVERY OF URBAN HEALTH CARE, THE CENTER WILL CONTINUE ITS LEADERSHIP ROLE IN EDUCATING HEALTHCARE PROVIDERS, CONSUMERS, AND THE PUBLIC IN THE AREAS OF CULTURAL AWARENESS AND SENSITIVITY WITH A SPECIAL COMMITMENT TO ASSURING EQUAL ACCESS TO QUALITY HEALTHCARE FOR ALL. 17 17 365 0 0 0 8630557 8443051 17414668 20551539 1881 9918 123633 210089 26170739 29214597 0 0 0 0 13934315 15338593 0 0 0 8872390 10836964 22806705 26175557 3364034 3039040 13680478 17011073 6629390 6733535 7051088 10277538 X THE CENTER IS DEDICATED TO PROVIDING HIGH-QUALITY PRIMARY AND PREVENTIVE HEALTHCARE, WITH A MAJOR FOCUS ON HEALTH EDUCATION/WELLNESS PROMOTION, AND THE REQUIREMENT TO MEET OR EXCEED PATIENT/CUSTOMER EXPECTATIONS. AS A TRENDSETTER IN THE DELIVERY OF URBAN HEALTH CARE, THE CENTER WILL CONTINUE ITS LEADERSHIP ROLE IN EDUCATING HEALTHCARE PROVIDERS, CONSUMERS, AND THE PUBLIC IN THE AREAS OF CULTURAL AWARENESS AND SENSITIVITY WITH A SPECIAL COMMITMENT TO ASSURING EQUAL ACCESS TO QUALITY HEALTHCARE FOR ALL. 0 0 22844685 20771546 THE CORPORATION PROVIDES GENERAL FAMILY PRACTICE SERVICES INCLUDING PREVENTION, CHRONIC ILLNESS, AND IMMUNIZATIONS. ALSO PROVIDES PEDIATRIC SERVICES AND OB/GYN SERVICES INCLUDING PRE-NATAL CARE AND DELIVERIES AND SOME GYNECOLOGICAL SURGERY. THE CORPORATION ALSO PROVIDES COMPREHENSIVE DENTAL AND HYGIENE SERVICES INCLUDING PEDIATRIC DENTISTRY AND SOME SURGERY (I.E. ROOT CANALS) TO PATIENTS. THE CORPORATION ALSO PROVIDES MENTAL HEALTH SERVICES INCLUDING DIAGNOSTIC CONSULTATIONS, MENTAL HEALTH SCREENINGS AND SHORT TERM COUNSELING. OPTOMETRY SERVICES ARE PROVIDED, WHICH INCLUDE VISUAL EXAMS, PRESCRIPTION LENSES, AND SCREENING AND EVALUATIONS. PODIATRY SERVICES ARE OFFERED FOR GENERAL FOOT CARE AND DIABETIC FOOT CARE. THE CORPORATION PROVIDES CASE MANAGEMENT AND CARE COORDINATION SERVICES TO ELIMINATE BARRIERS TO CARE IN TREATMENT AND ADHERENCE OF MEDICATION; TO HELP PATIENTS HAVE A BETTER AWARENESS OF THEIR HEALTH CARE AND THE PROGRESSION OF INFECTION; AND TO HELP PATIENTS SEE THE NEED TO REDUCE THEIR RISK OF EXPOSING OTHERS OR SECONDARY EXPOSURE TO THEMSELVES. THE CORPORATION HAD APPROXIMATELY 111,000 VISITS DURING 2013. 22844685 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 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 0 0 0 1 56 0 1 365 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X JONATHAN CLUNE 5854235800 82 HOLLAND STREET ROCHESTER NY 14605 DAVID BROADBENT MD VICE CHAIR 1.00 X X 0 0 0 CINDY BECKER RN MS MBA DIRECTOR 1.00 X 0 0 0 BUDDHI SHRESTHA DDS MS PHD BOARD CHAIR 1.00 X X 0 0 0 PAMELA JOHNSON DIRECTOR 1.00 X 0 0 0 HILDA ROSARIO-ESCHER DIRECTOR 1.00 X 0 0 0 FATHER LAURENCE TRACY DIRECTOR 1.00 X 0 0 0 S DOLLY MALIK PHD DIRECTOR 1.00 X 0 0 0 CARLOS GARCIA DIRECTOR 1.00 X 0 0 0 ISSE ABUKAR DIRECTOR 1.00 X 0 0 0 MIGUEL MELENDEZ DIRECTOR 1.00 X 0 0 0 GAYNELLE WETHERS SECRETARY 1.00 X X 0 0 0 SHAPELLE THOMPSON DIRECTOR 1.00 X 0 0 0 ALLEN WILLIAMS TREASURER 1.00 X X 0 0 0 CHRISTINE JOHNSON DIRECTOR 1.00 X 0 0 0 SAMMY NDIVE DIRECTOR 1.00 X 0 0 0 KATHLEEN PRINGLE FOUNDATION BOARD CHAIR 1.00 X 0 0 0 TRACY ARCHIE FOUNDATION VICE CHAIR 1.00 X 0 0 0 JONATHAN CLUNE CFO 40.00 X 78041 0 10081 DR JANICE HARBIN DDS CEO 40.00 X 136527 0 11873 LAURIE DONOHUE MD CMO 40.00 X 135215 0 8322 JASON DUNN COO 40.00 X 103185 0 11842 SAKINAH MILLER MD PHYSICIAN 40.00 X 128078 0 8322 NASHAT ATALLA MD PHYSICIAN 40.00 X 141151 0 8322 SAMUEL ROSATI PHYSICIAN 40.00 X 202319 0 3153 FETHIYE ERSAN DDS DENTIST 40.00 X 131230 0 8318 RICHARD KENNEDY MD PHYSICIAN 40.00 X 128110 0 12779 1183856 0 83012 17 0 1 0 ECLINICALWORKS PO BOX 847950 BOSTON MA 022847950 INFORMATION TECHNOLOGY PROVIDER 197029 RIDGE AUTOMOTIVE 14 FRANKLIN STREET SUITE 800 ROCHESTER NY 14604 LANDLORD 190095 COVERALL SERVICE COMPANY 8860 COLUMBIA 100 PKWY SUITE 401 COLUMBIA MD 21045 CLEANING SERVICES 178869 PRONEXUS 171 SULLYS TRAIL PITTSFORD NY 14534 CONSULTANT 101540 4 7382771 1060280 8443051 MEDICAID & MEDICARE 900099 11719731 11719731 340B REVENUE 900099 4909525 4909525 OTHER THIRD-PARTY PAYOR 900099 3800642 3800642 SELF-PAY 900099 106846 106846 CONTRACTED SERVICES 900099 14795 14795 20551539 9918 9918 OTHER 900099 210089 210089 210089 29214597 20771546 0 0 X 509999 87443 422556 11456642 10193397 1263245 366881 301641 65240 1790579 1447741 342838 1214492 962731 251761 116792 93434 23358 53377 42702 10675 3854495 3410829 443666 2774415 2710385 64030 1175690 974701 200989 108664 63289 45375 1088055 1049457 38598 110778 66586 44192 BAD DEBT EXPENSE 1217358 1217358 MISCELLANEOUS 227560 113211 114349 CLIENT DISCOUNTS 109780 109780 26175557 22844685 3330872 0 5500345 9073898 1154198 1475655 2751495 2287634 125978 12246669 8238599 4148462 4008070 165816 13680478 17011073 2368833 2518443 2645838 2873633 968592 932592 646127 408867 6629390 6733535 X 7051088 10212038 65500 7051088 10277538 13680478 17011073 X 3039040 187410 X 0 1 X 1 1 1 X 3676865 3926382 5832059 8630557 8443051 30508914 3676865 3926382 5832059 8630557 8443051 30508914 30508914 8404 4649 6418 1881 9918 31270 75453 266383 335037 123633 210089 1010595 31550779 58932044 0.96700 0.95780 X 37450 37450 7391426 3892315 3499111 4702348 4346284 356064 115445 115445 4008070 ACCRUED PENSION EXPENSE 406497 DUE TO AFFILIATE 2370 408867 X PART X, LINE 2: FOR TAX-EXEMPT ENTITIES, THEIR TAX-EXEMPT STATUS ITSELF IS DEEMED TO BE AN UNCERTAINTY, SINCE EVENTS COULD POTENTIALLY OCCUR TO JEOPARDIZE THEIR TAX-EXEMPT STATUS. AS OF DECEMBER 31, 2013, THE ORGANIZATION DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. THE ORGANIZATION FILES INFORMATIONAL RETURNS IN THE U.S. FEDERAL JURISDICATION AND NEW YORK STATE. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2009. 1 X X X 0 0 0 0 0 0 0 0 0 SAMUEL ROSATI PHYSICIAN 202319 0 0 0 0 0 6081 0 0 0 208400 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE CEO, CFO AND THE FINANCE/AUDIT COMMITTEE. IT IS THEN MADE AVAILABLE TO THE BOARD OF DIRECTORS TO REVIEW, PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY IS REVIEWED AND UPDATED ANNUALLY BY THE CEO AND THE BOARD CHAIRPERSON. ALL EMPLOYEES REVIEW THE POLICY AND SIGN A CONFLICT OF INTEREST STATEMENT DURING ORIENTATION. BOARD MEMBERS REVIEW THE POLICY AND SIGN A CONFLICT OF INTEREST STATEMENT UPON JOINING THE BOARD. THE POLICY IS MONITORED AND ENFORCED BY THE HUMAN RESOURCES DEPARTMENT, IN CONJUNCTION WITH THE CEO. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS APPROVES THE AMOUNT OF ALL COMPENSATION FOR THE CEO/PRESIDENT OF THE CORPORATION. IN DOING THIS, THEY CONSIDER TOTAL COMPENSATION INCLUDING SALARY AND BENEFITS. THE BOARD OBTAINS AND CONSIDERS DATA CONCERNING COMPARABLE COMPENSATION PAID TO SIMILAR OFFICERS IN LIKE CIRCUMSTANCES. FORM 990, PART VI, SECTION C, LINE 19 THE CENTER MAKES ITS GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT AND PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,410,829. MANAGEMENT AND GENERAL EXPENSES 443,666. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,854,495. FORM 990, PART XI, LINE 9: CHANGE IN FUNDED STATUS OF PENSION PLAN 187,410. ANTHONY L JORDAN FOUNDATION 82 HOLLAND STREET ROCHESTER NY 14605 161408256 PROVIDE FUNDING TO SUPPORT OPERATIONS OF ANTHONY L JORDAN HEALTH CORPORATION NY 501(C)3 LINE 11A TYPE I ANTHONY L JORDAN HEALTH CORPORATION 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0