FURP.ORG / PUBLIC DATA EXPLORER

OPEN DOOR FAMILY MEDICAL CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
OPEN DOOR FAMILY MEDICAL CENTER INC (EIN 13-2813103)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-06-25
IRS object ID
201221779349300312
Schema version
2011v1.2
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)
Timestamp2012-06-25T09:36:12-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN420714325EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCGLADREY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11185 AVENUE OF THE AMERICASAddressLine1
CityNEW YORKCity
StateNYState
ZIP Code100362602ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN132813103EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1OPEN DOOR FAMILY MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlOPENNameControl
Phone9145021470Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1165 MAIN STREETAddressLine1
CityOSSININGCity
StateNYState
ZIP Code10562ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLINDSAY C FARRELLName
TitlePRESIDENT AND CEOTitle
Phone9145021470Phone
Date Signed2012-06-25DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMARTIN GREIFName
PTINP00029738PTIN
Phone2123721000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLINDSAY C FARRELLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1165 MAIN STREETAddressLine1
CityOSSININGCity
StateNYState
ZIP Code10562ZIPCode
FieldValueIRS element (for citing)
Gross Receipts46530107GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.OPENDOORMEDICAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1975YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionOPEN DOOR FAMILY MEDICAL CENTER PROVIDES QUALITY PRIMARY HEALTH CARE AND HUMAN SERVICES AT AFFORDABLE PRICES TO THE COMMUNITY, PARTICULARLY LOW-INCOME, UNDER-SERVED RESIDENTS AND THOSE LACKING ACCESS TO HEALTH CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members20NbrIndependentVotingMembers
Total Nbr Employees375TotalNbrEmployees
Total Nbr Volunteers358TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year8526604ContributionsGrantsPriorYear
Contributions Grants Current Year10756507ContributionsGrantsCurrentYear
Program Service Revenue Prior Year21602843ProgramServiceRevenuePriorYear
Program Service Revenue CY24500364ProgramServiceRevenueCY
Investment Income Prior Year211346InvestmentIncomePriorYear
Investment Income Current Year155851InvestmentIncomeCurrentYear
Other Revenue Prior Year338569OtherRevenuePriorYear
Other Revenue Current Year377091OtherRevenueCurrentYear
Total Revenue Prior Year30679362TotalRevenuePriorYear
Total Revenue Current Year35789813TotalRevenueCurrentYear
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 Year17571541SalariesEtcPriorYear
Salaries Etc Current Year18591714SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8960254OtherExpensePriorYear
Other Expenses Current Year8400165OtherExpensesCurrentYear
Total Expenses Prior Year26531795TotalExpensesPriorYear
Total Expenses Current Year26991879TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4147567RevenuesLessExpensesPriorYear
Revenues Less Expenses CY8797934RevenuesLessExpensesCY
Total Assets BOY32801136TotalAssetsBOY
Total Assets EOY39065935TotalAssetsEOY
Total Liabilities BOY10786990TotalLiabilitiesBOY
Total Liabilities EOY8771656TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY22014146NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY30294279NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF THE OPEN DOOR FAMILY MEDICAL CENTER, INC. IS TO PROVIDE QUALITY PRIMARY HEALTH CARE AND HUMAN SERVICES AT AFFORDABLE PRICES TO THE COMMUNITY, PARTICULARLY LOW-INCOME, UNDER-SERVED RESIDENTS AND THOSE LACKING ACCESS TO HEALTH CARE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense16536570Expense
Revenue19289943Revenue
DescriptionOPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 33,687 MEDICAL PATIENTS THAT GENERATED 127,345 VISITS IN 2011.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2935586Expense
Revenue4419505Revenue
DescriptionOPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 13,558 DENTAL PATIENTS THAT GENERATED 32,023 VISITS IN 2011.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1393925Expense
Revenue790916Revenue
DescriptionOPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 1,871 MENTAL HEALTH PATIENTS THAT GENERATED 7,549 VISITS IN 2011.Description
FieldValueIRS element (for citing)
Total Program Service Expense20866081TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
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 Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
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 Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109636NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees375NumberOfEmployees
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 Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members20NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
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 Line1MARIA MAZZOTTABusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9145021470TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1165 MAIN STREETAddressLine1
CityOSSININGCity
StateNYState
ZIP Code10562ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
TYLER BEEBE
BOARD MEMBER1.00X000
CHARLES CHEHEBAR
BOARD MEMBER1.00X000
JOHN CONYERS
BOARD MEMBER1.00X000
WALTER EDGE
BOARD MEMBER1.00X000
JENNIFER GURAHIAN
BOARD MEMBER1.00X000
DORIAN LINDSAY
BOARD MEMBER1.00X000
AMY MCNAMARA
BOARD MEMBER1.00X000
TONY MEJIAS
BOARD MEMBER1.00X000
KEVIN NELSON
BOARD MEMBER1.00X000
MARIA M PEREZ
BOARD MEMBER1.00X000
MARGOTH PILLA
BOARD MEMBER1.00X000
ROSA ROJAS
BOARD MEMBER1.00X000
DIANA SCHAEFER
SECRETARY1.00X000X
HOWARD S SCHRADER
BOARD MEMBER1.00X000
DAVID K SHERMAN
TREASURER1.00X000X
STEWART TABIN
CHAIRMAN1.00X000X
ROSA TAYLOR
BOARD MEMBER1.00X000
ANDRES VALDESPINO
VICE CHAIRMAN1.00X000X
LUIS VICETTI
BOARD MEMBER1.00X000
DONNA WADE
BOARD MEMBER1.00X000
LINDSAY C FARRELL
PRESIDENT & CEO33.80271509015187X
MARIA MAZZOTTA
CHIEF FINANCIAL OFFICER33.2016602703464X
DAREN WU
CHIEF MEDICAL OFFICER37.50248121010634X
JANET H BOZZONE
DIRECTOR OF DENTAL SERVICES37.50201423010117X
ANITA WILENKIN
CHIEF OPERATING OFFICER37.50178385025840X
BRUCE M SHAFFER
PODIATRIST37.50171587010367X
ASAF COHEN
FAMILY PRACTICE PHYSICIAN37.50161779013119X
THOMAS YUEN
FAMILY PRACTICE PHYSICIAN37.50155998026183X
PATRICIA J MEYER
FAMILY PRACTICE PHYSICIAN37.5015708109150X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1711910TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation124061TotalOtherCompensation
Number Individuals GT100 K30NumberIndividualsGT100K
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
COMPREHENSIVE EYE SERVICES
PO BOX 187ARMONKNY10504EYE CLINIC225526
ECLINICAL WORKS
110 TURNPIKE ROAD SUITE 308WESTBOROMA01581ECW SUPPORT & E-SUBSCRIBING164457
WESTCHESTER INSTITUTE OF HUMAN DEVELOPME
CEDAR HALL RM322VALHALLANY10595PROJECT LAUNCH EVALUATOR117301
MCGLADREY & PULLEN LLP
1185 AVENUE OF THE AMERICASNEW YORKNY10036AUDIT/TAX PREPARATION107905
FELDSMAN TUCKER LEIFER FIDELL LLC
2001 L STREET NW 2ND FLOORWASHINGTONDC20036LEGAL SERVICES102471
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Federated Campaigns10000FederatedCampaigns
Related Organizations20000RelatedOrganizations
Government Grants9838961GovernmentGrants
All Other Contributions887546AllOtherContributions
Total Contributions10756507TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICAID6214001374920013749200
UNCOMPENSATED CARE62140038879863887986
CHILD HEALTH PLUS62140030782543078254
SELF-PAY62140026698222669822
MEDICARE621400600005600005

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column515097TotalRevenueColumn
Related Or Exempt Function Income515097RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue24500364TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column201594TotalRevenueColumn
Exclusion$201,594ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities10694551Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities10740294Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-45743Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-45743TotalRevenueColumn
Exclusion-$45,743ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
REIMB SALARIES & FRING900099365623$365,623
MISC. REVENUE90009911468$11,468
FieldValueIRS element (for citing)
Total Other Revenue377091TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column35789813TotalRevenueColumn
Related Or Exempt Function Income24500364RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$532,942ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total921894Total
Program Services733942ProgramServices
Management And General187952ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total14470577Total
Program Services11607593ProgramServices
Management And General2862984ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total678134Total
Program Services539879ProgramServices
Management And General138255ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1439736Total
Program Services1146209ProgramServices
Management And General293527ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1081373Total
Program Services860907ProgramServices
Management And General220466ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total116969Total
Management And General116969ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total120335Total
Management And General120335ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total73127Total
Management And General73127ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1116215Total
Program Services517076ProgramServices
Management And General599139ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total12312Total
Management And General12312ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1485848Total
Program Services1120103ProgramServices
Management And General365745ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total141107Total
Management And General141107ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1000932Total
Program Services842782ProgramServices
Management And General158150ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total31288Total
Program Services22404ProgramServices
Management And General8884ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total164875Total
Program Services82339ProgramServices
Management And General82536ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total332281Total
Program Services282439ProgramServices
Management And General49842ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1358857Total
Program Services1155028ProgramServices
Management And General203829ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total186431Total
Program Services158466ProgramServices
Management And General27965ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PHARMACEUTICALS668519668519
LABORATORY FEES435841435841
MISCELLANEOUS33998929213647853
DATA PROCESSING24979257534192258

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total565447Total
Program Services342884ProgramServices
Management And General222563ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total26991879Total
Program Services20866081ProgramServices
Management And General6125798ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4861550BOY
EOY5444209EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY714211BOY
EOY479555EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY780672BOY
EOY956090EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4458925BOY
EOY6345663EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY218854BOY
EOY282442EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis25808957LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec11665584LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY14726794BOY
EOY14143373EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6430393BOY
EOY10779176EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY609737BOY
EOY635427EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32801136BOY
EOY39065935EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4084994BOY
EOY4967650EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6508180BOY
EOY3739492EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY193816BOY
EOY64514EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY10786990BOY
EOY8771656EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY21945479BOY
EOY30210368EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY68667BOY
EOY83911EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY22014146BOY
EOY30294279EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32801136BOY
EOY39065935EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses8797934ReconcilationRevenueExpenses
Reconcilation Other Changes-517801ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6350528CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6469111CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6890084CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8526604CurrentTaxYearMinus1Year
Current Tax Year10756507CurrentTaxYear
Total38992834Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6350528CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6469111CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6890084CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8526604CurrentTaxYearMinus1Year
Current Tax Year10756507CurrentTaxYear
Total38992834Total
FieldValueIRS element (for citing)
Public Support Total17038992834PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years45075CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years75938CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years48675CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year153335CurrentTaxYearMinus1Year
Current Tax Year201594CurrentTaxYear
Total524617Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5106CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years20985CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5676CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year338569CurrentTaxYearMinus1Year
Current Tax Year377091CurrentTaxYear
Total747427Total
FieldValueIRS element (for citing)
Total Support40264878TotalSupport
Gross Receipts From Admissions Etc100046855GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.96840PublicSupportPertcentage170
Public Support Pertcent Prior Year0.98000PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE MANAGEMENT FEE INCOMEGeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1740016OtherCostOrOtherBasis
Book Value1740016BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2274217OtherCostOrOtherBasis
Depreciation1340733Depreciation
Book Value933484BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis13312328OtherCostOrOtherBasis
Depreciation5747954Depreciation
Book Value7564374BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3290696OtherCostOrOtherBasis
Depreciation2620564Depreciation
Book Value670132BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5191700OtherCostOrOtherBasis
Depreciation1956333Depreciation
Book Value3235367BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings14143373TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCAPITAL LEASE PAYABLEDescription
Amount$64,514Amount
FieldValueIRS element (for citing)
Total Of Amounts64514TotalOfAmounts
Total Revenue35789813TotalRevenue
Total Expenses26991879TotalExpenses
Excess Or Deficit For Year8797934ExcessOrDeficitForYear
Net Unrealized GL On Investments-21952NetUnrealizedGLOnInvestments
Other-$495,849OtherAmount
Total Adjustments-517801TotalAdjustments
Excess Or Deficit Per FS8280133ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt37002993TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-21952NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities257691DonatedSrvcAndUseOfFacilities
Other Revenues1416191OtherRevenues
Revenue Not Rptd F9901651930RevenueNotRptdF990
Revenue Subtotal35351063RevenueSubtotal
Investment Expenses Not Included73127InvestmentExpensesNotIncluded
Other Revenues Not Included365623OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt438750RevenueNotRptdOnFinStmt
Total Revenue Per Form99035789813TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt27937908TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities257691DonatedServicesUseOfFacilities
Other Expenses Included761465OtherExpensesIncluded
Expenses Not Rptd F9901019156ExpensesNotRptdF990
Expenses Subtotal26918752ExpensesSubtotal
Investment Expenses Not Included273127InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt73127ExpensesNotRptdOnFinStmt
Total Expenses Per Form99026991879TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:MANAGEMENT EVALUATED THE CORPORATION'S TAX POSITIONS AND CONCLUDED THAT THE CORPORATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. WITH FEW EXCEPTIONS, THE CORPORATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2008, WHICH IS THE STANDARD STATUTE OF LIMITATIONS LOOK-BACK PERIOD.
PART XI, LINE 8 - OTHER ADJUSTMENTS:PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -495,849.
PART XII, LINE 2D - OTHER ADJUSTMENTS:REVENUE OF RELATED ENTITIES 1,416,191.
PART XII, LINE 4B - OTHER ADJUSTMENTS:REIMBURSED SALARIES/FRINGE 365,623.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 495,849. REIMBURSED SALARIES/FRINGE -365,623. EXPENSES OF RELATED ENTITIES 631,239.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
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 Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base 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
LINDSAY C FARRELL
245962025000054708575066120286696000
MARIA MAZZOTTA
15839807500012900034640169491000
DAREN WU
217460030497016408575020590258755000
JANET H BOZZONE
182128018604069107091030260211540000
ANITA WILENKIN
170714070000671065680192720204225000
BRUCE M SHAFFER
17095700063006057043100181954000
ASAF COHEN
13467802700809305837072820174898000
THOMAS YUEN
151877040050116058000203830182181000
PATRICIA J MEYER
138641018001043902389067610166231000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 6THE FOLLOWING INDIVIDUALS, LISTED ON PART VII, RECEIVED INCENTIVE BONUSES, WHICH ARE BASED ON THE NET EARNINGS OF EACH INDIVIDUAL'S BUSINESS SEGMENT, DURING THE YEAR ENDED 12/31/11: DAREN WU - $24,997 JANET H. BOZZONE - $16,104 ASAF COHEN - $27,008 THOMAS YUEN - $4,005 PATRICIA J. MEYER - $18,001
PART I, LINE 7THE FOLLOWING INDIVIDUALS, LISTED ON PART VII, RECEIVED NON-FIXED PAYMENTS, DETERMINED BY THE BOARD, DURING THE YEAR ENDED 12/31/11: LINDSAY C. FARRELL - $25,000 MARIA MAZZOTTA - $7,500 DAREN WU - $5,500 JANET H. BOZZONE - $2,500 ANITA WILENKIN - $7,000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6OPEN DOOR, INC. IS THE SOLE MEMBER OF OPEN DOOR FAMILY MEDICAL CENTER, INC.
FORM 990, PART VI, SECTION B, LINE 11OPEN DOOR FAMILY MEDICAL CENTER ENGAGES THE SERVICES OF AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE ANNUAL FORM 990 IN CONJUNCTION WITH ITS ANNUAL AUDITED FINANCIAL STATEMENTS. THE PRESIDENT/CEO AND CFO REVIEW THE FORM 990 AND SCHEDULES FOR ACCURACY. IN MAY 2012, THE FORM 990, FOR THE YEAR ENDED DECEMBER 31, 2011, WAS PRESENTED TO THE FINANCE COMMITTEE AND BOARD MEMBERS FOR REVIEW PRIOR TO ITS SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12CTHROUGH ITS CORPORATE COMPLIANCE PROGRAM, THE CENTER'S COMPLIANCE COMMITTEE, WHICH IS COMPRISED OF AN INTERDISCIPLINARY TEAM OF STAFF MEMBERS, MEETS ON A MONTHLY BASIS TO MONITOR THE RESULTS OF ITS INTERNAL AND EXTERNAL AUDITS AND INVESTIGATIONS TO ENSURE COMPLIANCE WITH ITS POLICIES WHICH INCLUDE ANY CONFLICT OF INTEREST. 1. THE MANAGEMENT OF THE OPEN DOOR WILL DEDICATE SUCH RESOURCES AS ARE NECESSARY TO DEVELOP AND IMPLEMENT AN EFFECTIVE CORPORATE COMPLIANCE PROGRAM DESIGNED TO PROMOTE ADHERENCE TO ALL APPLICABLE LAWS, INCLUDING THE STATUTES, REGULATIONS AND REQUIREMENTS APPLICABLE TO MEDICAID, MEDICARE AND OTHER FEDERAL AND STATE HEALTH CARE PROGRAMS. 2. THE COMPLIANCE PROGRAM WILL MEET OR EXCEED THE COMPONENTS OF AN EFFECTIVE COMPLIANCE PROGRAM AS IDENTIFIED BY THE OIG IN ITS COMPLIANCE PROGRAM GUIDANCES. THESE COMPONENTS INCLUDE: A) CONDUCTING INTERNAL MONITORING AND AUDITING; B) IMPLEMENTING WRITTEN STANDARDS AND POLICIES AND PROCEDURES; C) DESIGNATING A COMPLIANCE OFFICER AND COMMITTEE; D) CONDUCTING APPROPRIATE TRAINING AND EDUCATION; E) RESPONDING APPROPRIATELY TO DETECTED OFFENSES AND DEVELOPING CORRECTIVE ACTION; F) DEVELOPING OPEN LINES OF COMMUNICATION; G) ENFORCING DISCIPLINARY STANDARDS THROUGH WELL-PUBLICIZED GUIDELINES. 3. THE BOARD RECOGNIZES THAT THE DEVELOPMENT AND IMPLEMENTATION OF A COMPREHENSIVE AND EFFECTIVE CORPORATE COMPLIANCE PROGRAM WILL BE BOTH TIME CONSUMING AND COSTLY. ACCORDINGLY, OPEN DOOR MANAGEMENT IS DIRECTED TO PROCEED WITH THE DEVELOPMENT AND IMPLEMENTATION OF A PROGRAM BY FOCUSING ON COMPLIANCE FUNCTIONS HAVING PRIORITY AND ON PRACTICE AREAS IDENTIFIED AS POTENTIAL "RISK AREAS" BY THE OPEN DOOR OR, MORE GENERALLY, BY THE OIG AND OTHER FEDERAL OR STATE GOVERNMENT ENFORCEMENT AGENCIES. CONSISTENT WITH THE OIG'S COMPLIANCE PROGRAM GUIDANCE'S, MANAGEMENT WILL PROCEED WITH THE DEVELOPMENT AND IMPLEMENTATION OF THE CORPORATE COMPLIANCE PROGRAM AND SHALL PROVIDE PERIODIC PROGRESS REPORTS TO THE BOARD. 4. BASED ON THE FOREGOING, THE BOARD DIRECTS OPEN DOOR MANAGEMENT TO SEND A LETTER TO ALL OPEN DOOR EMPLOYEES, CONSULTANTS, VENDORS AND VOLUNTEERS ADVISING THEM OF THE INTENDED COMPLIANCE PROGRAM.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE COMMITTEE OF THE BOARD CONDUCTS PARITY STUDIES TO EVALUATE EXECUTIVE COMPENSATION. THE BOARD APPROVES THE CHIEF EXECUTIVE OFFICER'S GOALS ANNUALLY AND ANNUAL PERFORMANCE.
FORM 990, PART VI, SECTION C, LINE 19OPEN DOOR DOES MAKE ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC BY POSTING ON THE ORGANIZATION'S WEBSITE; PROVIDING COPIES UPON REQUEST; AND INSPECTION AT AN OFFICE OF THE ORGANIZATION. THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST, AT THE ORGANIZATION'S LOCATION.
FORM 990, PART VIITHE ORGANIZATION, IN A FULL TRANSPARENCY POSTURE TO REPORTING, IS REPORTING ALL BENEFITS IN FULL IN PART VII, COLUMN F AND NOT APPLYING THE $10,000 PER ITEM EXCEPTION FOR CERTAIN BENEFITS.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -21,952. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -495,849. TOTAL TO FORM 990, PART XI, LINE 5: -517,801.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART VIILINDSAY FARRELL WORKED 3.8 HOURS/WEEK FOR OPEN DOOR FOUNDATION, INC. MARIA MAZZOTTA WORKED 1.8 HOURS/WEEK FOR OPEN DOOR FOUNDATION, INC.# OF HOURS WORKED FOR RELATED ENTITIES

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
OPEN DOOR FOUNDATION INC
165 MAIN STREETOSSININGNY10562133598184FUNDRAISING/DEVELOPMENTNY501(C)(3)LINE 7OPEN DOOR INC0
OPEN DOOR INC
165 MAIN STREETOSSININGNY10562133585009SUPPORTING ORGANIZATIONNY501(C)(3)LINE 11B, II0

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1OPEN DOOR LEASING CORPBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1165 MAIN STREETAddressLine1
CityOSSININGCity
StateNYState
ZIP Code10562ZIPCode
FieldValueIRS element (for citing)
EIN201726717EIN
Primary ActivityLEASING SPACEPrimaryActivity
Legal Domicile StateNYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1OPEN DOOR FAMILY MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Share Of Total Income278724ShareOfTotalIncome
Share Of EOY Assets12000ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1OPEN DOOR LEASING CORPBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeJTransactionType
Amount Involved257528AmountInvolved
Method Of Amt DeterminationCOSTMethodOfAmtDetermination