LMC PHYSICIAN SERVICES PC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
LMC PHYSICIAN SERVICES PC (EIN 11-3192423)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201303189349308390
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-14T17:49:26-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1TWO JERICHO PLAZAAddressLine1
CityJERICHOCity
StateNYState
ZIP Code11753ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN113192423EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LMC PHYSICIAN SERVICES PCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLMCPNameControl
Phone7186307611Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 55TH STREET NO 2-36AddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11220ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameALAN SICKLESName
TitlePRESIDENTTitle
Phone7186307611Phone
Date Signed2013-11-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCHRISTINE KAWECKIName
PTINP00743140PTIN
Phone5169187000Phone
Date Prepared2013-11-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonALAN SICKLESNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1150 55TH STREET NO 2-36AddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11220ZIPCode
FieldValueIRS element (for citing)
Gross Receipts20624006GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE O.ActivityOrMissionDescription
Nbr Voting Members Governing Body1NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees150TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year16699442ProgramServiceRevenuePriorYear
Program Service Revenue CY20306360ProgramServiceRevenueCY
Investment Income Prior Year2146InvestmentIncomePriorYear
Investment Income Current Year1614InvestmentIncomeCurrentYear
Other Revenue Prior Year824939OtherRevenuePriorYear
Other Revenue Current Year316032OtherRevenueCurrentYear
Total Revenue Prior Year17526527TotalRevenuePriorYear
Total Revenue Current Year20624006TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year18909138SalariesEtcPriorYear
Salaries Etc Current Year22685159SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5075390OtherExpensePriorYear
Other Expenses Current Year5841466OtherExpensesCurrentYear
Total Expenses Prior Year23984528TotalExpensesPriorYear
Total Expenses Current Year28526625TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-6458001RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-7902619RevenuesLessExpensesCY
Total Assets BOY3122537TotalAssetsBOY
Total Assets EOY3300888TotalAssetsEOY
Total Liabilities BOY1687708TotalLiabilitiesBOY
Total Liabilities EOY2205679TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1434829NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1095209NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE O.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense26363795Expense
Revenue20306360Revenue
DescriptionSEE SCHEDULE O.Description
Total Program Service Expense26363795TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109628NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees150NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members1NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ALAN SICKLESBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7186307611TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1150 55TH STREETAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11220ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
ALAN SICKLES MD
PRESIDENT40.00XX573834016650
MICHAEL GERLING MD
PHYSICIAN40.002046636027383X
FAUSTO VINCES DO
PHYSICIAN40.00566237027377X
SALMAN AZHAR MD
PHYSICIAN40.00676956016155X
THOMAS LYON MD
PHYSICIAN33.80590885024090X
BRADFORD GOFF
PHYSICIAN40.00408395016859X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4862943TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation128514TotalOtherCompensation
Number Individuals GT100 K53NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MD EVERYWHERE
26 CENTRAL AVENUEHAUPPAUGENY11788BILLING & AUDIT SERVICES556788
CADUCEUS INC
30 MONTGOMERY STRRET SUITE 720JERSEY CITYNJ073023841BILLING & AUDIT SERVICES405830
LOCUMTENENSCOM
PO BOX 405547ATLANTAGA303845547LOCUM TENENS229245
OTOLARYNGOLOGY ASSOCIATES
7333 6TH AVEBROOKLYNNY11209PHYSICIAN SERVICES224283
GPK COLORECTAL SURGERY PLLC
23 FOSTER AVENUESTATEN ISLANDNY10314PHYSICIAN SERVICES131763
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUDescription
Business Code621110BusinessCode
Total Revenue Column20306360TotalRevenueColumn
Related Or Exempt Function Income20306360RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue20306360TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1614TotalRevenueColumn
Exclusion$1,614ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionREBATESDescription
Business Code900099BusinessCode
Total Revenue Column316032TotalRevenueColumn
Related Or Exempt Function Income316032RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue316032TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column20624006TotalRevenueColumn
Related Or Exempt Function Income20622392RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,614ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total590484Total
Program Services574182ProgramServices
Management And General16302ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total19650312Total
Program Services19107807ProgramServices
Management And General542505ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total409846Total
Program Services393981ProgramServices
Management And General15865ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1012777Total
Program Services933989ProgramServices
Management And General78788ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1021740Total
Program Services977035ProgramServices
Management And General44705ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total201006Total
Management And General201006ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total54905Total
Management And General54905ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total36456Total
Management And General36456ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total967979Total
Program Services967979ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total691922Total
Program Services691922ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total543295Total
Program Services543295ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total42523Total
Program Services42523ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1986648Total
Program Services1986648ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
BILLING EXPENSES962618962618
MEDICAL SUPPLIES139672139672
COLLECTION FEES8071280712
BANK FEES4258442584

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total91146Total
Program Services4762ProgramServices
Management And General86384ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total28526625Total
Program Services26363795ProgramServices
Management And General2162830ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY165407EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY775795BOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY644785BOY
EOY1373372EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY528165BOY
EOY508113EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis597467LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec200689LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY379589BOY
EOY396778EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY794203BOY
EOY857218EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3122537BOY
EOY3300888EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1472768BOY
EOY1970240EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY214940BOY
EOY235439EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1687708BOY
EOY2205679EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1434829BOY
EOY1095209EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1434829BOY
EOY1095209EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3122537BOY
EOY3300888EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-7902619ReconcilationRevenueExpenses
Reconcilation Other Changes7562999ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Written IRS DeterminationXWrittenIRSDetermination
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1LUTHERAN MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
EIN111839567EIN
Type Of OrganizationHOSPITALTypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$28,526,625Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts28526625SumOfAmounts

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis307423OtherCostOrOtherBasis
Depreciation11982Depreciation
Book Value295441BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis290044OtherCostOrOtherBasis
Depreciation188707Depreciation
Book Value101337BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings396778TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATES695268
DUE FROM THIRD PARTY PAYORS161950
FieldValueIRS element (for citing)
Total Book Value Other Assets857218TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATESDescription
Amount$235,439Amount
FieldValueIRS element (for citing)
Total Of Amounts235439TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ALAN SICKLES MD
PRESIDENT2737830287095012956010000066500590484000
MICHAEL GERLING MD
PHYSICIAN5245470150528001680901000001738302074019000
FAUSTO VINCES DO
PHYSICIAN5580200298505232098500175270593614000
SALMAN AZHAR MD
PHYSICIAN4217610240745014450010000061550693111000
THOMAS LYON MD
PHYSICIAN57125202183017450098500142400614975000
BRADFORD GOFF
PHYSICIAN32391506000002448009850070090425254000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 7ReturnReference
ExplanationBONUS INFORMATION THE ORGANIZATION'S EMPLOYED PHYSICIANS ARE ELIGIBLE TO RECEIVE A BONUS BASED ON THE TERMS OF THEIR INDIVIDUAL CONTRACTS. THE EMPLOYED PHYSICIANS' CONTRACTS PROVIDE FOR A FIXED ANNUAL SALARY FOR EACH PHYSICIAN; HOWEVER, THAT SALARY MAY BE SUPPLEMENTED IF, ON AN ANNUAL BASIS, THE PHYSICIAN'S PROFESSIONAL FEE COLLECTIONS EXCEED A DEFINED THRESHOLD. THE PHYSICIAN IS ELIGIBLE TO RECEIVE A BONUS (DETERMINED WITHIN NINETY DAYS FOLLOWING THE END OF THE YEAR). THE PHYSICIANS' CONTRACTS SPECIFY THAT NO COMPENSATION PAYMENTS MAY EXCEED THE FAIR MARKET VALUE OF THE SERVICES PROVIDED BY THE PHYSICIAN.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART I, LINE 1HEALTHCARE PROVIDER OF PHYSICIAN SERVICES IN CONJUNCTION WITH, AND IN SUPPORT OF, LUTHERAN MEDICAL CENTER.
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1LMC PHYSICIAN SERVICES, PC ("PC") IS FORMED FOR THE SOLE PURPOSE OF PROMOTING HEALTH FOR THE BENEFIT OF THE COMMUNITY BY SERVING A LARGE AND INDEFINITE CLASS. THE ORGANIZATION PROMOTES HEALTH BY ENGAGING IN THE PROFESSION OF MEDICINE AND PROVIDING MEDICAL SERVICES, IN A MANNER THAT IS EXCLUSIVELY CHARITABLE WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE PROVISION OF MEDICAL SERVICES HAS BEEN CARRIED ON SINCE THE INCEPTION OF THE ORGANIZATION IN 1994. THE PC OPERATES IN SUPPORT OF LUTHERAN MEDICAL CENTER. LUTHERAN MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF NEW YORK, AND A CHARITABLE, TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. LUTHERAN MEDICAL CENTER IS AN ACUTE CARE HOSPITAL THAT CONDUCTS CHARITABLE AND HOSPITAL ACTIVITIES. THE PC PROVIDES PROFESSIONAL MEDICAL SERVICES TO PATIENTS, WITHOUT REGARD FOR THE PATIENT'S ABILITY TO PAY. THE ORGANIZATION HAS ADOPTED THE CHARITY CARE POLICY OF LUTHERAN MEDICAL CENTER.
PROGRAM SERVICE STATEMENTFORM 990, PART III, LINE 4ALUTHERAN MEDICAL CENTER PHYSICIAN SERVICES, PC IS A PROFESSIONAL CORPORATION THAT PROVIDES MULTI-SPECIALTY MEDICAL AND SURGICAL SERVICES TO LUTHERAN MEDICAL CENTER AND THE SURROUNDING SOUTHWEST BROOKLYN COMMUNITIES. MANY OF THE PC'S EMPLOYED PHYSICIANS ALSO PROVIDE SERVICES TO THE LUTHERAN FAMILY HEALTH CENTER CLINICS, LOCATED AT LUTHERAN MEDICAL CENTER AND, A SATELLITE OFFICE LOCATED IN BAY RIDGE. MAJOR SPECIALTIES REPRESENTED BY EMPLOYEES OF THE PC ARE AS FOLLOWS: MEDICINE- INTERNAL MEDICINE, CARDIOLOGY, NEUROLOGY, PHYSICAL MEDICINE AND REHABILITATION; MEDICAL ONCOLOGY, RHEUMATOLOGY, ENDOCRINOLOGY; SURGERY- THORACIC, VASCULAR, HAND/PLASTIC, UROLOGY, OPHTHALMOLOGY, ORTHOPEDICS, GENERAL/TRAUMA, BARIATRIC; OBGYN- REPRODUCTIVE ENDOCRINOLOGY, UROLOGICAL GYN; GYN ONCOLOGY; BEHAVIORAL HEALTH- PSYCHIATRY AND SUBSTANCE ABUSE. IN 2012, MORE THAN 155,563 VISITS AND PROCEDURES WERE PERFORMED ON LUTHERAN MEDICAL CENTER PATIENTS, WITHOUT REGARD FOR THE PATIENT'S ABILITY TO PAY.
FORM 990, PART IV, LINE 12BLMC PHYSICIANS SERVICES, P.C. IS INCLUDED IN A COMBINED AUDITED FINANCIAL STATEMENT FOR THE YEAR ENDING DECEMBER 31ST, 2012 THE COMBINED FINANCIAL STATEMENTS ARE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES IN THE UNITED STATES OF AMERICA ("GAAP"). THE COMBINED FINANCIAL STATEMENTS INCLUDE THE ACCOUNTS OF LUTHERAN MEDICAL CENTER AND ALL OF ITS AFFILIATED ORGANIZATIONS. PER THE INSTRUCTIONS TO THE FORM 990, THE ORGANIZATION IS REQUIRED TO RESPOND "YES" TO PART IV, QUESTION 12B IF THE ORGANIZATION IS PART OF A CONSOLIDATED FINANCIAL STATEMENT. SINCE SCTING "YES" TO THIS QUESTION MAY BE MISCONSTRUED, THE TAXPAYER IS ATTACHING THIS EXPLANATION TO ITS FORM 990.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION IS A PROFESSIONAL SERVICE CORPORATION ("PC") WITH ONE SHAREHOLDER. UNDER APPLICABLE NYS LAW, ONLY A LICENSED PHYSICIAN MAY HOLD SHARES IN THE PC. DR. ALAN SICKLES, IS THE SOLE SHAREHOLDER OF THE PC, AND PURSUANT TO A SHAREHOLDER AGREEMENT AMONG DR. SICKLES, THE PC AND THE MEDICAL CENTER, THE SHAREHOLDER HAS VERY LIMITED AUTHORITY. IN PARTICULAR, THE SHAREHOLDER MAY NOT TRANSFER OR ENCUMBER THE SHARES OR DECLARE DISTRIBUTIONS WITHOUT THE EXPRESS CONSENT OF THE MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE SHAREHOLDER HAS THE AUTHORITY TO APPOINT THE DIRECTORS AND OFFICERS OF THE PC.
FORM 990, PART VI, SECTION A, LINE 7BPURSUANT TO THE SHAREHOLDER AGREEMENT, DR. ALAN SICKLES HAS LIMITED AUTHORITY AND ALL DECISIONS ARE CONTROLLED BY LUTHERAN MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION HAS ANSWERED THIS QUESTION "NO" AS THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS REVIEWED BY THE VICE PRESIDENT OF FINANCE OF THE ORGANIZATION'S PARENT ORGANIZATION, LUTHERAN MEDICAL CENTER. A COPY OF THE FORM 990 IS PROVIDED TO THE SOLE DIRECTOR, DR. ALAN SICKLES, FOR HIS COMMENT AND REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION OPERATES UNDER THE CONFLICT OF INTEREST POLICY OF ITS PARENT ORGANIZATION, LUTHERAN MEDICAL CENTER. THE PRESIDENT AND SOLE DIRECTOR, DR. ALAN SICKLES, IS REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST ON TWO ANNUAL SURVEY/QUESTIONNAIRES SUBMITTED TO THE MEDICAL CENTER'S GENERAL COUNSEL. ONE OF THE QUESTIONNAIRES PERTAINS TO HIS ROLE AS A SENIOR EXECUTIVE FOR LUTHERAN MEDICAL CENTER AND THE OTHER, MORE COMPREHENSIVE, QUESTIONNAIRE PERTAINS TO HIS ROLE AS PRESIDENT AND SOLE DIRECTOR FOR LMC PHYSICIAN SERVICES, PC. THE TWO SUBMITTED QUESTIONNAIRES ARE REVIEWED BY THE MEDICAL CENTER'S GENERAL COUNSEL TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15SENIOR MANAGEMENT AT THE PARENT ORGANIZATION, LUTHERAN MEDICAL CENTER, REGULARLY REVIEWS VARIOUS OBJECTIVE DATA SOURCES THAT FACTOR INTO COMPENSATION FOR EMPLOYED AND CONTRACTED PHYSICIANS AND GROUPS PROVIDING SERVICES TO THE ORGANIZATION. THESE SOURCES INCLUDE NATIONAL AND REGIONAL SURVEY SAMPLES BY PHYSICIAN CLINICAL SPECIALTY, AS PUBLISHED BY SULLIVAN COTTER AND AS PURCHASED FROM OTHER CONSULTANTS, WHICH GUIDE THE ESTABLISHMENT OF FAIR MARKET VALUE FOR EACH PHYSICIAN'S/GROUP'S COMPENSATION LEVEL IN THE ORGANIZATION. WITH RESPECT TO CERTAIN PHYSICIANS WHO MIGHT BE CONSIDERED "LUMINARIES" OR WHOSE COMPENSATION FALLS INTO AN OUTLIER CATEGORY IN THE CLINICAL SPECIALTY, LMC SEEKS ADVICE AND OPINIONS FROM OUTSIDE CONSULTANTS WHO SPECIALIZE IN THIS WORK.
FORM 990, PART VI, SECTION C, LINE 19THE TAXPAYER MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC BY RETAINING A COPY OF EACH AT ITS HEAD OFFICES. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION DOES NOT OBTAIN AUDITED FINANCIAL STATEMENTS SO THESE ARE NOT MADE AVAILABLE TO THE PUBLIC. THE SOLE PHYSICIAN-SHAREHOLDER OF LMC PHYSICIAN SERVICES, P.C. RECEIVES HER COMPENSATION THROUGH THE ORGANIZATION'S PARENT ORGANIZATION, LUTHERAN MEDICAL CENTER. THE LUTHERAN MEDICAL CENTER BOARD OF TRUSTEES ENGAGES SULLIVAN COTTER & ASSOCIATES, INC. TO PROVIDE ANNUAL REPORTS AND SUPPORTING DATA RELATIVE TO EXECUTIVE COMPENSATION. THE COMPENSATION COMMITTEE, ACTING ON BEHALF OF THE FULL LUTHERAN BOARD OF TRUSTEES, RECEIVES AND REVIEWS THESE REPORTS WHICH CONTAIN: A) A MARKET ANALYSIS OF THE TOTAL COMPENSATION LEVELS OF SENIOR EXECUTIVES IN RELATION TO THEIR PEERS IN THE MARKETPLACE; B) A REVIEW OF CURRENT COMPENSATION AND BENEFIT PLAN DESIGNS TO ENSURE COMPETITIVENESS TO THE MARKETPLACE; AND C) COMPLIANCE WITH STATE AND/OR FEDERAL REGULATIONS. THE COMPENSATION COMMITTEE RELIES UPON THE DATA AND RECOMMENDATIONS PROVIDED BY SULLIVAN COTTER & ASSOCIATES TO DETERMINE THE COMPENSATION LEVEL OF THE CEO. FOR THE OTHER KEY EXECUTIVE POSITIONS, THE CEO RECOMMENDS ADJUSTMENTS TO THE COMMITTEE WHO, IN TURN, REVIEW THESE RECOMMENDATIONS UTILIZING THE SULLIVAN COTTER & ASSOCIATES REPORTS AND APPROVES, DISAPPROVES OR ALTERS THE PROPOSALS OF THE CEO FOR THE OTHER SENIOR EXECUTIVES.
FORM 990, PART VI, LINES 13 & 14THE ORGANIZATION OPERATES UNDER THE WHISTLEBLOWER AND DOCUMENT RETENTION POLICY OF ITS PARENT ORGANIZATION, LUTHERAN MEDICAL CENTER
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 9:TRANSFERS OF NET ASSETS FROM RELATED ENTITIES 7,562,999. ROUNDING

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
LUTHERAN MEDICAL CENTER
150 55TH STREETBROOKLYNNY11220111839567HOSPITALNY501(C)(3)3N/A0
LUTHERAN AUGUSTANA CECR INC
5434 2ND AVEBROOKLYNNY11220112150953EXTENDED CARENY501(C)(3)9N/A0
OHP PHSP INC
5800 3RD AVENUEBROOKLYNNY11220113245559INSURANCENY501(C)(4)N/AN/A0
SHORE HILL HOUSING COMPANY INC
9000 SHORE ROADBROOKLYNNY11209237405105HOUSINGNY501(C)(3)7N/A0
HARBOR HILL HOUSING
150 55TH STREETBROOKLYNNY11220113152691HOUSINGNY501(C)(3)9N/A0
SUNSET BAY COMMUNITY SERVICES
150 55TH STREETBROOKLYNNY11220112439925DAY CARE & SENIOR SERVICESNY501(C)(3)7N/A0
LMC COMMUNITY FOUNDATION
150 55TH STREETBROOKLYNNY11220237439784SUPPORT ORG.NY501(C)(3)11BN/A0
COMMUNITY CARE ORGANLZATLON
246 55TH STREET APT AA4BROOKLYNNY11220113001682HOME HEALTHNY501(C)(3)9N/A0
SUNSET GARDENS HOUSING CORP
150 55TH STREETBROOKLYNNY11220203461755HOUSINGNY501(C)(3)7N/A0
LMC HEALTH SYSTEM INC
150 55TH STREETBROOKLYNNY11220113589771SUPPORT ORG.NY501(C)(3)11AN/A0
SHORE ROAD RADIOLOGY ASSOCIATES PC
150 55TH STREETBROOKLYNNY11220112665457HEALTHCARENY501(C)(3)11CN/A0

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodePrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
SHORE ROAD COMMUNITY SERVICES
150 55TH STREETBROOKLYNNY11220NURSING & HOUSINGNYLMC COMMUNITY FOUNDATIONC0
SHORE HILL HOUSING ASSOCIATES GP INC
150 55TH STREETBROOKLYNNY11220HOUSINGNYC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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