2014-09-29T14:19:33-05:00 2013-12-31 221478099 COHNREZNICK LLP 180 GLASTONBURY BOULEVARD GLASTONBURY CT 06033 990 2013-01-01 060863942 COMMUNITY HEALTH SERVICES INC COMM 8602499625 500 ALBANY AVENUE HARTFORD CT 06120 GREGORY L STANTON CEO 8602499625 2014-09-29 1 PAUL BALLASY P00852868 8606333000 2013 2015-11-30 17:44:51Z GREGORY L STANTON 500 ALBANY AVENUE HARTFORD CT 06120 15375516 0 X WWW.CHSHARTFORD.ORG X 1967 CT TO PROVIDE MEDICAL SERVICES FOR THE RESIDENTS OF THE GREATER HARTFORD CONNECTICUT AREA. TO PROVIDE QUALITY HEALTH CARE SERVICES TO LOW AND MODERATE INCOME INDIVIDUALS IN THE GREATER HARTFORD CONNECTICUT AREA REGARDLESS OF ABILITY TO PAY. 13 13 193 30 0 0 6050041 5810745 10552652 8775958 624 -66963 456676 74931 17059993 14594671 0 0 0 0 10596592 11347469 0 0 0 4943028 5068036 15539620 16415505 1520373 -1820834 20446737 18591617 2123437 2089151 18323300 16502466 TO PROVIDE MEDICAL SERVICES FOR THE RESIDENTS OF THE GREATER HARTFORD CONNECTICUT AREA. TO PROVIDE QUALITY HEALTH CARE SERVICES TO LOW AND MODERATE INCOME INDIVIDUALS IN THE GREATER HARTFORD CONNECTICUT AREA REGARDLESS OF ABILITY TO PAY. 0 0 11943277 8775958 PROVIDE QUALITY HEALTH CARE SERVICES TO PATIENTS WHO ARE LOW AND MODERATE INCOME INDIVIDUALS IN THE GREATER HARTFORD CONNECTICUT AREA. THERE WERE 74,950 PATIENT VISITS IN 2013. 11943277 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 47 0 1 193 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CT X SCOTT BRABANT 8602499625 500 ALBANY AVENUE HARTFORD CT 06120 AIGNER MITCHELL CHAIRPERSON 1.00 X X 0 0 0 JABER ASLANZADEH VICE CHAIRMAN 1.00 X X 0 0 0 MISHONE DONELSON TREASURER 1.00 X X 0 0 0 JACQUELINE MCDERMOTT-SELMAN SECRETARY 1.00 X X 0 0 0 TAWANA DILLARD DIRECTOR 0.50 X 0 0 0 SHERWOOD LEWIS DIRECTOR 0.50 X 0 0 0 FLOYD PAULLING DIRECTOR 0.50 X 0 0 0 CLORINDA SOLDEVILA DIRECTOR 0.50 X 0 0 0 CHARLES WILLIAMS DIRECTOR 0.50 X 0 0 0 ROBERT HARRIS DIRECTOR 0.50 X 0 0 0 KAYMARA JUBREY DIRECTOR 0.50 X 0 0 0 JOHN SODIPO DIRECTOR 0.50 X 0 0 0 ROSEMARY TATE DIRECTOR 0.50 X 0 0 0 KHADIJA ABDUL-SALAAM DIRECTOR 0.50 X 0 0 0 RICHARD ORDER DIRECTOR 0.50 X 0 0 0 KRISTEN CLARK DIRECTOR 0.50 X 0 0 0 MICHAEL WILLIAMS DIRECTOR 0.50 X 0 0 0 KENNETH GREEN CHIEF EXECUTIVE OFFICER (THROUGH 1/11/2013) 40.00 X 65912 0 947 JOHVONNE CLAYBOURNE DO CHIEF MEDICAL OFFICER 40.00 X 130864 0 11967 ANDREA MONTGOMERY ACTING CHIEF EXECUTIVE OFFICER (THROUGH 7/21/2013) 40.00 X 194243 0 6267 SCOTT BRABANT CHIEF FINANCIAL OFFICER 40.00 X 129057 0 23261 GREGORY STANTON CHIEF EXECUTIVE OFFICER 40.00 X 69900 0 4666 RITU DUTTA DIRECTOR OF WOMEN'S HEALTH 40.00 X 246935 0 21850 MONTRESSOR UPSHAW DIRECTOR OF DENTISTRY 40.00 X 151506 0 8947 KATHLEEN TUMMILLO DIRECTOR OF ADULT MEDICINE 40.00 X 153750 0 17627 SHARJEEL AHMAD ASSOCIATE DIRECTOR OF ADUL 40.00 X 123245 0 9928 JULIE EAPEN PROVIDER 40.00 X 131933 0 0 ANN-MARIE SURETTE PROVIDER 40.00 X 150115 0 11415 IRVING BUCHBINDER PROVIDER 40.00 X 122982 0 4952 SHERWIN TUCKER PROVIDER 40.00 X 119385 0 3465 1789827 0 125292 18 0 1 0 QUALITY SYSTEMS INC PO BOX 809390 CHICAGO IL 60680 SOFTWARE INSTALLATION & IMPLEMENTATION 522162 OR&L CONSTRUCTION 2 SUMMIT PLACE BRANFORD CT 06405 CONSTRUCTION MANAGEMENT 497217 REGAN TECHNOLOGIES CORPORATION 7 BARNES INDUSTRIAL RD S WALLINGFORD CT 06492 IT INFRASTRUCTURE 276537 COMPHEALTH PO BOX 972651 DALLAS TX 75397 HEALTHCARE STAFFING 154687 SUCCESS EHS ONE METROPLEX DRIVE SUITE 500 BIRMINGHAM AL 35209 SOFTWARE PRODUCTS 118053 9 5657869 152876 285249 5810745 PATIENT SERVICE 620000 8775958 8775958 8775958 549 549 44100 0 44100 44100 44100 713333 780845 -67512 -67512 -67512 OTHER REVENUE 900099 30831 30831 30831 14594671 8775958 0 7968 1237697 866387 371310 7999403 5599547 2399856 104417 73128 31289 1352357 946650 405707 653595 457516 196079 111411 77988 33423 44400 31080 13320 1156632 849122 307510 764377 728363 36014 254457 189779 64678 837601 633623 203978 4930 2465 2465 79464 39732 39732 47208 33046 14162 993011 724897 268114 139335 115019 24316 VACCINES 285249 285249 PROVISION FOR BAD DEBTS 124063 124063 LAUNDRY AND LINENS 71894 53620 18274 154004 112003 42001 16415505 11943277 4472228 0 2266487 1205195 608017 610039 721433 210430 681697 491176 170357 242135 165881 162932 22711916 7064421 15813824 15647495 8908 12082 10133 10133 20446737 18591617 1523677 1105034 599760 984117 2123437 2089151 X 18315827 16490925 7473 11541 18323300 16502466 20446737 18591617 -1820834 0 X X 0 1 X 1 1 1 X 5819655 6143203 8776058 6050041 5810745 32599702 5819655 6143203 8776058 6050041 5810745 32599702 32599702 735 518 774 48787 44649 95463 34084 48802 48166 408513 30831 570396 33265561 52607778 0.98000 0.98240 X SCHEDULE A, PART II, LINE 10, EXPLANATION FOR OTHER INCOME: 2009 AMOUNT: $34,084 2010 AMOUNT: $48,802 2011 AMOUNT: $48,166 2012 AMOUNT: $408,513 2013 AMOUNT: $30,831 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 133022 133022 18330846 5293116 13037730 510383 51677 458706 3737665 1719628 2018037 15647495 X 14538120 -124063 -124063 14662183 -67512 -67512 14594671 16358954 67512 67512 16291442 124063 124063 16415505 PART X, LINE 2: THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2013. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO CALENDAR YEAR 2010 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE CENTER HAS UNRELATED BUSINESS INCOME TAXES, IT WILL RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENT OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -124,063. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT -67,512. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT 67,512. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 124,063. X X X 1 0 0 0 0 0 0 1 0 ANDREA MONTGOMERY ACTING CHIEF EXECUTIVE OFFICER (THRO 194243 0 0 0 0 0 4355 0 1912 0 200510 0 0 0 SCOTT BRABANT CHIEF FINANCIAL OFFICER 129057 0 0 0 0 0 300 0 22961 0 152318 0 0 0 RITU DUTTA DIRECTOR OF WOMEN'S HEALTH 246935 0 0 0 0 0 10018 0 11832 0 268785 0 0 0 MONTRESSOR UPSHAW DIRECTOR OF DENTISTRY 151506 0 0 0 0 0 0 0 8947 0 160453 0 0 0 KATHLEEN TUMMILLO DIRECTOR OF ADULT MEDICINE 153750 0 0 0 0 0 4446 0 13181 0 171377 0 0 0 ANN-MARIE SURETTE PROVIDER 142615 0 7500 0 0 0 3415 0 8000 0 161530 0 0 0 PART I, LINE 4A KENNETH GREEN - $57,000 ANDREA MONTGOMERY - $26,137 PART I, LINE 7 INCENTIVE COMPENSATION: ANN-MARIE SURETTE: $7,500 - BONUS ANDREA MONTGOMERY ACTING CHIEF EXECUTIVE OFFICER (THROUGH 7/21/2013) 11550 CONSULTING FEES 0 X 1 285249 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE DEPARTMENT ALONG WITH THE CEO REVIEWS THE FORM 990 AND IT IS THEN FORWARDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW. THE 990 IS THEN DISTRIBUTED TO THE FULL BOARD FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C COMMUNITY HEALTH SERVICES, INC. REQUIRES THAT ALL EMPLOYEES AND BOARD MEMBERS SIGN A WRITTEN CONFLICT OF INTEREST POLICY. THIS CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE CORPORATE COMPLIANCE OFFICER AND THE CORPORATE COMPLIANCE TEAM WHICH MEETS ON A QUARTERLY BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS, IN AN EXECUTIVE MEETING, DETERMINES THE COMPENSATION OF THE CEO. THEY USE A LOCAL NONPROFIT CEO COMPENSATION SURVEY AS A GUIDELINE. THE CEO DETERMINES THE COMPENSATION OF THE ORGANIZATION'S EMPLOYEES. HE IS GUIDED BY STATE AND NATIONAL GUIDELINES AND SURVEYS AS WELL AS A SURVEY DONE YEARLY FOR THE COMMUNITY HEALTH CENTERS IN CONNECTICUT BY THE COMMUNITY HEALTH CENTER ASSOCIATION OF CONNECTICUT. FORM 990, PART VI, SECTION C, LINE 19 COMMUNITY HEALTH SERVICES' GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THERE HAVE BEEN NO CHANGES IN THE OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR.