2013-05-14T14:08:22-05:00 2012-09-30 271728945 O'CONNOR DAVIES LLP 665 FIFTH AVENUE NEW YORK NY 10022 990 2011-10-01 131782482 PHYSICIANS' HOME INC PHYS 2128364318 445 PARK AVENUE 9TH FLOOR NEW YORK NY 100228632 JOSEPH B CLEARY MD 2128364318 2013-05-10 1 GARRETT M HIGGINS CPA P00543209 2122862600 2013-05-10 2011 2016-02-24 21:20:13Z JOSEPH B CLEARY MD 445 PARK AVENUE 9TH FLOOR NEW YORK NY 100228632 1319955 0 X HTTP://WWW.PHYSICIANSHOME.ORG/ X 1919 NY PHYSICIANS' HOME PROVIDES REGULAR FINANCIAL AID TO NEEDY PHYSICIANS OR THEIR DEPENDENTS. DURING THE YEAR FORTY-ONE INDIVIDUALS RECEIVED HELP TOTALING $290,000. THIRTY-TWO BENEFICIARIES WERE PHYSICIANS AND NINE WERE FAMILY MEMBERS. 21 19 4 37 0 0 156312 66296 0 0 284972 180972 0 0 441284 247268 273723 290330 0 0 55892 64443 0 0 23614 134748 133582 464363 488355 -23079 -241087 6198178 6913845 4337 24483 6193841 6889362 X SEE SCHEDULE O 0 0 323401 290330 PHYSICIANS' HOME PROVIDES REGULAR FINANCIAL AID TO NEEDY PHYSICIANS OR IMMEDIATE FAMILY MEMBERS OF A DECEASED PHYSICIAN. TO BE ELIGIBLE, THE PHYSICIAN SHOULD HAVE OBTAINED A NEW YORK STATE MEDICAL LICENSE AND HAVE PRACTICED IN THE STATE. ASSISTANCE IS GIVEN WITH THE GOAL BEING TO HELP PROVIDE FOR MODEST LIVING REQUIREMENTS. NO REPAYMENT IS EXPECTED. THE ORGANIZATION PROVIDES SOCIAL SERVICE EVALUATIONS TO AID BENEFICIARIES IN OBTAINING ASSISTANCE TO WHICH THEY ARE ENTITLED FROM GOVERNMENTAL AND OTHER ORGANIZATIONS. DURING THE YEAR THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS EVALUATED THE NEED OF EACH BENEFICIARY FOR CONTINUED ASSISTANCE. IT ALSO EVALUATED SEVEN NEW APPLICATIONS FOR AID, ACCEPTING FIVE. THE ORGANIZATION PROVIDED $290,000 IN DIRECT ASSISTANCE TO THIRTY-TWO PHYSICIANS AND NINE FAMILY MEMBERS DURING THE YEAR. 323401 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 0 0 1 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 0 0 1 1 0 4 1 0 0 0 0 0 0 0 0 0 0 X 21 19 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X X JOSEPH B CLEARY MD 2128364318 445 PARK AVENUE 9TH FLOOR NEW YORK NY 10022 X JOSEPH B CLEARY MD 8.00 X X 30072 0 0 MARTHA REDO EEQ 1.00 X X 0 0 0 DONALD D FAGER ESQ 1.00 X X 0 0 0 ALLEN MEAD MD 0.10 X X 0 0 0 ANDREW E SAMA MD 1.00 X 0 0 0 BRUCE C HORTEN MD 0.20 X 0 0 0 DAVID S KARAN MD 1.00 X 0 0 0 EDRIS BLOOMFIELD 0.00 X 0 0 0 EDWARD J AMSLER ESQ 0.20 X 0 0 0 EMILY SONNENBLICK MD 0.00 X 0 0 0 FAZLULLAH MOQTADERI MD 1.00 X 0 0 0 FRANCIS IACOBELLIS MD 0.20 X 0 0 0 FRANK IAQUINTA MD 0.00 X 0 0 0 GEORGE DERMKSIAN MD 0.50 X 0 0 0 JANET POPE-SULLIVAN 0.50 X 0 0 0 JOEL ARCHER MD 1.00 X X 0 0 0 JOHN A MCCLUNG MD 0.20 X 0 0 0 MARY DODD LMSW 1.00 X 200 0 0 SHERWOOD JACOBSON MD 0.00 X 0 0 0 STEPHEN CONNOLLY MD 0.10 X 0 0 0 WILLIAM HEALY MD 0.10 X 0 0 0 30272 0 0 0 0 0 0 0 3142 63154 66296 185453 185453 1068206 1072687 -4481 -4481 -4481 247268 0 0 180972 200 200 290130 290130 30272 15236 7518 7518 25723 12861 6431 6431 1500 750 375 375 6948 3474 1737 1737 30252 30252 26641 26641 6873 6873 14883 14203 680 45818 45818 1434 750 684 4300 4300 886 886 2495 2495 488355 323401 141340 23614 300 72477 388067 543281 11195 14227 898 14486 12113 2423 2373 4511499 5486304 1276294 785885 8400 8400 6198178 6913845 4337 24483 4337 24483 X 5565073 5474709 785885 628768 628768 6193841 6889362 6198178 6913845 X -241087 936608 X X 0 1 1 X 0 X 72043 66059 54922 68218 66296 327538 72043 66059 54922 68218 66296 327538 4516 323022 167569 131067 158831 173744 185453 816664 1144202 0.28230 0.29700 X PHYSICIANS' HOME MAINTAINS AN ON-GOING PROGRAM OF SOLICITATION OF FUNDS FROM THE GENERAL PUBLIC. ANNUALLY IN NOVEMBER, THE ORGANIZATION SENDS AN APPEAL LETTER TO INDIVIDUALS WHO HAVE CONTRIBUTED IN THE PAST; AT REGULAR INTERVALS, USUALLY EVERY THIRD YEAR, THIS APPEAL IS SENT TO ALL PHYSICIANS PRACTICING IN NEW YORK STATE, REACHING APPROXIMATELY 55,000 INDIVIDUALS. IN 2012, PHYSICIANS' HOME, FOR THE FIRST TIME, PRODUCED A DONORS' JOURNAL. THIS PUBLICATION INCLUDED MESSAGES OF SUPPORT AND GRATITUDE FROM CONTRIBUTORS AND LISTED THE NAMES OF ALL CONTRIBUTORS. THE ORGANIZATION PLANS TO CONTINUE THE DONORS' JOURNAL AS PART OF ITS FUNDRAISING EFFORT.WITH THE 2012 APPEAL, THE ORGANIZATION ACCEPTED CONTRIBUTIONS BY CREDIT CARD FOR THE FIRST TIME. PHYSICIANS' HOME IS CURRENTLY EXPANDING ITS WEBSITE TO PROVIDE AN ATTRACTIVE PICTURE OF ITS HISTORY, MISSION, AND ORGANIZATION. THE ORGANIZATION'S INVESTMENT PORTFOLIO, AND RELATED INVESTMENT INCOME, IS THE RESULT OF SUBSTANTIAL CONTRIBUTIONS BY NUMEROUS MEMBERS OF THE PHYSICIAN AND NON-PHYSICIAN COMMUNITIES OVER MANY YEARS. THE PORTFOLIO HAS BEEN AUGMENTED BY NUMEROUS ESTATE LEGACIES OVER THE YEARS. DURING THE YEAR ENDED JUNE 30, 2012, PHYSICIANS HOME RECEIVED ABOUT 450 CONTRIBUTIONS, MOST FROM INDIVIDUALS. MEDICAL ORGANIZATIONS, SUCH AS COUNTY MEDICAL SOCIETIES, ALSO CONTRIBUTED.THE ORGANIZATION'S OFFICE IS STAFFED DAILY. THE EXECUTIVE COMMITTEE HOLDS REGULARLY SCHEDULED MEETINGS TO REVIEW BENEFICIARY CIRCUMSTANCES. CHECKS ARE DISBURSED TO BENEFICIARIES FROM THE ORGANIZATION'S OFFICE ON THE FIRST OF EACH MONTH. IN ADDITION TO REGULAR MONTHLY CHECKS, PHYSICIANS' HOME OFTEN MAKES DISBURSEMENTS TO MEET EMERGENCIES SHOULD A BENEFICIARY'S SITUATION WARRANT SUCH A PAYMENT.PHYSICIANS' HOME HAS A REPRESENTATIVE GOVERNING BODY. THE TWENTY-MEMBER BOARD OF DIRECTORS INCLUDES PRACTICING AND RETIRED PHYSICIANS WHO PARTICIPATE BECAUSE OF THEIR DEDICATION TO THE ORGANIZATION'S MISSION. THE BOARD ALSO INCLUDES A LICENSED SOCIAL WORKER, TWO ATTORNEYS, AND THE LEADER OF A CHARITABLE ORGANIZATION DEDICATED TO CHILDREN WITH CANCER. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 628768 628768 628768 628768 628768 628768 628768 628768 1.00000 0 0 14486 12113 2373 2373 BENEFICIAL INTEREST IN CHARITBALE REMAINDER TRUST 785885 F 785885 247268 488355 -241087 532093 339085 65430 936608 695521 844791 532093 65430 597523 247268 0 247268 488355 0 488355 0 488355 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE INTENDED TO GENERATE INCOME IN PERPETUITY. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE ORGANIZATION'S TAX RETURNS FOR ALL YEARS SINCE FISCAL 2009 REMAIN OPEN TO EXAMINATION BY THE RESPECTIVE TAXING AUTHORITIES. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF CHARITABLE REMAINDER TRUST 64,485. PRIOR PERIOD ADJUSTMENT TO UNREALIZED APPRECIATION ON INVESTMENTS 500. PRIOR PERIOD ADJUSTMENT TO CHANGE IN VALUE OF CHARITABLE REMAINDER TRUST 445. TOTAL TO SCHEDULE D, PART XI, LINE 8: 65,430. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF CHARITABLE REMAINDER TRUST 64,485. PRIOR PERIOD ADJUSTMENT TO UNREALIZED APPRECIATION ON INVESTMENTS 500. PRIOR PERIOD ADJUSTMENT TO CHANGE IN VALUE OF CHARITABLE REMAINDER TRUST 445. PART XI, PAGE 4, LINE 8: AS OF OCTOBER 1, 2011, THE ORGANIZATION RECORDED ADJUSTMENTS TO ITS OPENING NET ASSETS BALANCES RELATED TO A) AN INCREASE IN THE ESTIMATED FAIR VALUE OF AN AMOUNT RECEIVABLE FROM A TRUST WHICH TERMINATED DURING FISCAL 2011; B) AN INCREASE IN THE ESTIMATED FAIR VALUE OF A BENEFICIAL INTEREST IN A CHARITABLE REMAINDER TRUST DUE TO THE RECOMPUTATION OF THE ESTIMATED FAIR VALUE OF SUCH INTEREST; C) THE RECLASSIFICATION OF NET ASSETS PERTAINING TO A BENEFICIAL INTEREST IN A CHARITABLE REMAINDER TRUST FROM UNRESTRICTED TO TEMPORARILY RESTRICTED. NORTH AMERICA 0 0 INVESTMENTS 240684 0 0 0 0 0 0 240684 0 240684 0 0 1 0 0 0 METHOD USED TO ACCCOUNT FOR EXPENDITURES: SCHEDULE F, PART I, LINE 3: NOTE: ON JANUARY 12, 2012 THE ORGANIZATION PURCHASED A $100,000 CANADIAN PACIFIC RAILWAY COMPANY 4.45% NOTE DUE 3/15/2023. COST: $102,000. THIS BOND WAS PURCHASED ON THE OPEN MARKET IN THE US. NO FUNDS WENT TO A FOREIGN COUNTRY. 1 X FINANCIAL ASSISTANCE 41 290130 FMV PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: PHYSICIANS' HOME MAINTAINS DETAILED RECORDS ON ALL RECIPIENTS OF FINANCIAL ASSISTANCE. THESE RECORDS INCLUDE APPLICATIONS FOR ASSISTANCE ALONG WITH EVIDENCE PERTINENT TO CLAIMS OF FINANCIAL HARDSHIP AND MEDICAL DISABILITY. FOLLOW UP IS PERFORMED ON A REGULAR BASIS USING UPDATE FORMS REVIEWED BY THE EXECUTIVE COMMITTEE. ORGANIZATION MISSION STATEMENT FORM 990, PART III, LINE 1: PHYSICIANS' HOME WAS FOUNDED IN NEW YORK CITY IN 1919, BY SEVERAL PHYSICIANS WHO SAW A NEED TO HELP OTHER DOCTORS WHO WERE STRUGGLING FINANCIALLY. DURING THE EARLIEST YEARS PHYSICIANS' HOME WAS ACTUALLY A PHYSICAL STRUCTURE, LOCATED IN UPSTATE ALLEGANY COUNTY. IN TIME, IT WAS DECIDED THAT PHYSICIANS IN NEED COULD BEST BE SERVED BY PROVIDING MONTHLY FINANCIAL ASSISTANCE, HELPING THEM TO REMAIN IN THEIR OWN HOMES. THE MISSION OF THE ORGANIZATION HAS BEEN CARRIED OUT FOR THE PAST HALF-CENTURY THIS WAY. THE BASIC ELIGIBILITY REQUIREMENTS ARE THAT A DOCTOR HAS OBTAINED A NEW YORK STATE MEDICAL LICENSE, AND HAS PRACTICED IN THE STATE. IMMEDIATE FAMILY MEMBERS OF A DECEASED PHYSICIAN MAY ALSO BE ELIGIBLE. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTOR'S REVIEWS APPLICATIONS, AND ASSISTANCE IS GIVEN WITH THE GOAL BEING TO HELP PROVIDE FOR MODEST LIVING REQUIREMENTS. NO RE-PAYMENT IS EXPECTED. BENEFICIARY CIRCUMSTANCES ARE REVIEWED AT INTERVALS, TO DETERMINE THE NEED FOR CONTINUED ASSISTANCE. SOCIAL SERVICE INTERVIEWS AND EVALUATIONS ARE CARRIED OUT AS CALLED FOR IN INDIVIDUAL CASES. DURING OUR LAST YEAR, FISCAL YEAR ENDING SEPTEMBER 30, 2012, HELP WAS PROVIDED TO FORTY-ONE BENEFICIARIES, WHO RECEIVED A TOTAL OF $290,000 IN AID. A DONOR'S JOURNAL WAS INITIATED LAST YEAR, GIVING CONTRIBUTORS AN OPPORTUNITY TO EXPRESS GOOD WISHES ALONG WITH THEIR CONTRIBUTION. OUR FUND RAISING APPEAL PROVIDED $55,000; IN ADDITION, A LARGE DISTRIBUTION WAS RECEIVED FROM A LONG-STANDING TRUST FUND. WE LOOK FORWARD TO CONTINUING OUR ROLE IN ASSISTING NEW YORK STATE PHYSICIANS IN NEED. FORM 990, PART VI, SECTION A, LINE 6 PHYSICIANS' HOME HAS TWO (2) CLASSES OF MEMBERSHIP, CONTRIBUTING MEMBERS AND ADMINISTRATIVE MEMBERS. CONTRIBUTORS OF $20 OR MORE TO PHYSICIANS' HOME ARE CONTRIBUTING MEMBERS OF THE CORPORATION FOR THAT FISCAL YEAR. THOSE ELECTED BY THE MEMBERS TO BE DIRECTORS, TRUSTEES, OR OFFICERS OF THE CORPORATION ARE ADMINISTRATIVE MEMBERS. EACH CONTRIBUTING AND ADMINISTRATIVE MEMBER OF THE CORPORATION IS ENTITLED TO ONE VOTE, IN PERSON OR BY PROXY, AT ALL MEETINGS OF MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A PHYSICIANS' HOME HAS CONTRIBUTORY MEMBERS AND ADMINISTRATIVE MEMBERS. CONTRIBUTORY MEMBERS ARE THOSE INDIVIDUALS WHO CONTRIBUTE $20 OR MORE IN A GIVEN YEAR; EACH CONTRIBUTORY MEMBER MAY ATTEND THE ANNUAL MEETING OF THE ORGANIZATION, AND VOTE FOR THE GOVERNING BODY. MEMBERS OF THE GOVERNING BODY ARE CONSIDERED ADMINISTRATIVE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY APPROPRIATE OFFICERS AND THE INTERNAL ACCOUNTANT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, A PAPER COPY OF THE FORM 990 IS PROVIDED TO THE BOARD MEMBERS OF THE ORGANIZATION FOR ANY COMMENTS. ANY COMMENTS ARE THEN GROUPED, SUMMARIZED AND PROVIDED TO THE OUTSIDE ACCOUNTANTS. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C THE PHYSICIANS' HOME CONFLICT OF INTEREST POLICY HAS BEEN UPDATED TO COVER ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, ACCOUNTANT(S), AUDITOR(S), AND INVESTMENT MANAGER(S). THESE PERSONS RECEIVE A STATEMENT OF CONFLICT OF INTEREST POLICY (WHICH ALSO COVERS CONFIDENTIALITY AND WHISTLEBLOWER ACTIVITIES). THE CONFLICT OF INTEREST STATEMENT REQUIRES THAT PERSONS COVERED UNDER THE STATEMENT WILL DISCLOSE TO THE EXECUTIVE COMMITTEE ANY SUCH SITUATION. IF AND WHEN A POTENTIAL CONFLICT OF INTEREST IS DISCLOSED AND VALIDATED BY THE EXECUTIVE COMMITTEE, THE PERSON IS EXPECTED TO RECUSE HIMSELF/HERSELF FROM THE RELATED ACTIVITIES. FORM 990, PART VI, SECTION B, LINE 15A ONE MANAGEMENT OFFICIAL RECEIVES COMPENSATION, THE PRESIDENT. THIS COMPENSATION WAS APPROVED BY THE BOARD OF DIRECTORS IN 2007. NO REVIEW OF COMPARABLE DATA WAS CONSIDERED NECESSARY SINCE THE LEVEL OF COMPENSATION WAS DEEMED NOMINAL. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY STATEMENT, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC, UPON REQUEST. FORM 990, PART VII, COLUMN (B) BOARD MEMBER HOURS: BOARD MEMBER PARTICIPATION IS DOCUMENTED IN OUR MINUTES AND CAN BE SEEN BY A REVIEW OF OUR MINUTES FOR THE ANNUAL MEETING AND EXECUTIVE COMMITTEE MEETINGS, GOOD REPRESENTATION IS PRESENT TO PROVIDE DISCUSSION AND ADVICE IN REGARD TO THE ACTIVITIES OF THE ORGANIZATION . OF THE TWENTY-ONE DIRECTORS AND TRUSTEES THERE WERE FOUR WHO WERE UNABLE TO PARTICIPATE TO ANY EXTENT DURING THE YEAR. EXCEPT FOR ONE, THESE INDIVIDUALS ARE AT AN OLDER AGE, AND HAVE SERVED THE ORGANIZATION WELL OVER THE YEARS; THEY REMAIN ON THE BOARD IN PART AS A COURTESY TOWARD THEIR PREVIOUS SERVICE. DIRECTORS WILL BE PERIODICALLY INFORMED THAT PARTICIPATION BY ALL TO SOME DEGREE IS NECESSARY. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 532,093. PRIOR PERIOD ADJUSTMENTS: 339,085. CHANGE IN VALUE OF CHARITABLE REMAINDER TRUST 64,485. PRIOR PERIOD ADJUSTMENT TO UNREALIZED APPRECIATION ON INVESTMENTS 500. PRIOR PERIOD ADJUSTMENT TO CHANGE IN VALUE OF CHARITABLE REMAINDER TRUST 445. TOTAL TO FORM 990, PART XI, LINE 5: 936,608. FORM 990, PART XII, LINE 2C: THE PRESIDENT, IN CONSULTATION WITH TRUSTEES AND OFFICERS, IS RESPONSIBLE FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE HAS BEEN NO CHANGE IN THE PROCESS FROM THE PRIOR YEAR. FORM 990, PART VII: EXPLANATION OF PAYMENT TO MARY DODD: BOARD MEMBER MARY DODD RECEIVES NO COMPENSATION IN HER CAPACITY AS BOARD MEMBER AND OFFICER. SHE DOES RECEIVE COMPENSATION AS AN INDEPENDENT CONTRACTOR IN HER CAPACITY AS A SOCIAL SERVICE CONSULTANT TO PHYSICIANS' HOME, INC.