2011-09-23T08:40:46-05:00 2010-12-31 RSM MCGLADREY INC 1185 AVENUE OF THE AMERICAS NEW YORK NY 100362602 990 2010-01-01 132813103 OPEN DOOR FAMILY MEDICAL CENTER INC OPEN 9145021470 165 MAIN STREET OSSINING NY 10562 LINDSAY C FARRELL 9145021470 2011-09-21 1 MARTIN GREIF 2123721000 2010 2016-03-07 17:11:31Z NA LINDSAY C FARRELL 165 MAIN STREET OSSINING NY 10562 36767000 0 X WWW.OPENDOORMEDICAL.ORG X 1975 NY THE 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. 20 20 360 218 0 0 6890084 8526604 20675090 21602843 48685 211346 5676 338569 27619535 30679362 0 0 0 0 15472004 17571541 0 0 0 7621661 8960254 23093665 26531795 4525870 4147567 25766996 32801136 8343861 10786990 17423135 22014146 THE 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. 0 0 16046104 16819258 OPEN DOOR IS ONE OF THE LARGEST PROVIDERS OF HEALTH CARE FOR LOW INCOME PATIENTS IN WESTCHESTER, AND EMPHASIZES ACCESS BY MEANS OF A SLIDING SCALE FEE DISCOUNT, CONVENIENT HOURS AND LOCATIONS, AND MAINTAINING A BILINGUAL, MULTICULTURAL, AND CULTURALLY COMPETENT STAFF. MEDICAL SERVICES INCLUDE PRIMARY AND PREVENTIVE CARE FOR ALL AGES; ACUTE AND CHRONIC CARE SERVICES; OPTOMETRY, DERMATOLOGY, PODIATRY, WOMEN'S HEALTH, LABORATORY SERVICES, AND CASE MANAGEMENT. OPEN DOOR IS A JOINT COMMISSION ACCREDITED. OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 31,216 MEDICAL PATIENTS THAT GENERATED 116,341 VISITS IN 2010. 3000668 3725368 OPEN DOOR'S ORAL HEALTH SERVICE DELIVERY MODEL IS INTEGRATED WITH OUR MEDICAL CARE, IT IS CULTURALLY COMPETENT AND BILINGUAL, AND TARGETS THE UNIQUE NEEDS AND BARRIERS TO CARE OF OUR COMMUNITIES. SERVICES INCLUDE DIAGNOSTIC, PREVENTION, AND BASIC RESTORATIVE CARE, LIMITED ENDODONTICS AND PERIODONTICS, REMOVEABLE PROSTHETICS, ORAL SURGERY, AND EMERGENCY DENTAL CARE. OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 12,289 DENTAL PATIENTS THAT GENERATED 28,491 VISITS IN 2010. 984928 1058217 OPEN DOOR'S MENTAL HEALTH SERVICE DELIVERY IS ALSO INTEGRATED WITH OUR MEDICAL CARE, CULTURALLY COMPETENT, BILINGUAL, AND RESPONSIVE TO THE UNIQUE NEEDS OF OUR TARGET POPULATION. SERVICES INCLUDE BEHAVIORAL AND DEVELOPMENTAL HEALTH SCREENINGS, SOCIAL WORK, PSYCHOTHERAPY, PSYCHIATRIC EVALUATION AND PHARMACOLOGICAL MANAGEMENT, SUPPORT GROUPS, AND ABUSE SCREENING, INTERVENTION, PREVENTION AND EDUCATION. OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 1,588 MENTAL HEALTH PATIENTS THAT GENERATED 8,423 VISITS IN 2010. 20031700 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 29 0 1 360 1 0 0 0 0 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MARIA MAZZOTTA 9145021470 165 MAIN STREET OSSINING NY 10562 CHARLES CHEHEBAR 1.00 X X 0 0 0 AMY MCNAMARA 1.00 X 0 0 0 STEWART TABIN 1.00 X X 0 0 0 HOWARD S SCHRADER 1.00 X 0 0 0 MARIA M PEREZ 1.00 X X 0 0 0 LUIS VICETTI 1.00 X 0 0 0 WALTER EDGE 1.00 X 0 0 0 DIANA SCHAEFER 1.00 X X 0 0 0 DONNA WADE 1.00 X 0 0 0 JENNIFER GURAHIAN 1.00 X 0 0 0 ANDRES VALDESPINO 1.00 X 0 0 0 KEVIN NELSON 1.00 X 0 0 0 DAVID K SHERMAN 1.00 X 0 0 0 DORIAN LINDSAY 1.00 X 0 0 0 TONY MEJIAS 1.00 X 0 0 0 ROSA ROJAS 1.00 X 0 0 0 MARGOTH PILLA 1.00 X 0 0 0 TYLER BEEBE 1.00 X 0 0 0 JOHN CONYERS 1.00 X 0 0 0 ROSA TAYLOR 1.00 X 0 0 0 LINDSAY C FARRELL 33.80 X 272086 0 13690 MARIA MAZZOTTA 33.30 X 137739 0 11012 JANET H BOZZONE 38.00 X 205150 0 8393 DAREN WU 38.00 X 246355 0 9159 ASAF COHEN 38.00 X 183759 0 7182 JYOTHI PARAPURATH 38.00 X 180124 0 2458 BRUNO CASANOVA 38.00 X 177916 0 5766 ANITA WILENKIN 38.00 X 171982 0 17333 THOMAS YUEN 38.00 X 170206 0 16029 1745317 0 91022 27 0 1 0 COMPREHENSIVE EYE SERVICES PO BOX 187 ARMONK NY 10504 EYE CLINIC 238515 ECLINICAL WORKS 110 TURNPIKE ROAD SUITE 308 WESTBORO MA 01581 ECW SUPPORT & E-SUBSCRIBING 145660 MCGLADREY & PULLEN LLP 1185 AVENUE OF THE AMERICAS 19TH FL NEW YORK NY 10036 AUDIT/TAX PREPARATION 136650 3 8102518 424086 25300 8526604 MEDICAID 900099 11059287 11059287 CHILD HEALTH PLUS 900099 3726476 3726476 SELF-PAY 900099 3215034 3215034 UNCOMPENSATED CARE 900099 2529242 2529242 MEDICARE 900099 613230 613230 459574 459574 21602843 153335 153335 5963133 182516 5897023 190615 66110 -8099 58011 58011 REIMB SALARIES & FRING 900099 317037 317037 MISC. REVENUE 900099 21532 21532 338569 30679362 21602843 0 549915 908496 724919 183577 13742313 10965447 2776866 571150 455739 115411 1391423 1110262 281161 958159 764547 193612 81542 81542 142450 142450 50253 50253 1045128 708690 336438 41585 22822 18763 1730025 1375623 354402 268002 92542 175460 906975 752890 154085 30500 18063 12437 156681 50405 106276 315696 315696 1216826 504024 712802 175820 70471 105349 BAD DEBT EXPENSE 1118409 1118409 LABORATORY 599478 599478 MISCELLANEOUS 272906 233088 39818 REPAIRS & MAINTENANCE 243395 110365 133030 EQUIPMENT RENTAL 172331 38765 133566 392252 315151 77101 26531795 20031700 6500095 0 10348 11523 7541762 5564238 447337 780672 2555138 4458925 189658 218854 25118210 10391416 12374542 14726794 2000424 6430393 647787 609737 25766996 32801136 3855648 4084994 4257535 6508180 230678 193816 8343861 10786990 X 17423135 21945479 68667 17423135 22014146 25766996 32801136 X 4147567 443444 X X 0 1 1 X 1 1 X 5935079 6350528 6469111 6890084 8526604 34171406 5935079 6350528 6469111 6890084 8526604 34171406 34171406 45075 75938 48675 153335 323023 3665 5106 20985 5676 338569 374001 34868430 89050586 0.98000 0.99240 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE MANAGEMENT FEE INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1740016 1740016 2274217 1297307 976910 12452438 5022323 7430115 6069991 4071786 1998205 2581548 2581548 14726794 CAPITAL LEASE PAYABLE 193816 193816 30679362 26531795 4147567 385850 143047 -85453 443444 4591011 31158006 385850 143047 528897 30629109 50253 50253 30679362 26566995 0 26566995 50253 -85453 -35200 26531795 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ON JANUARY 1, 2009, THE CENTER ADOPTED THE ACCOUNTING STANDARD ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THIS GUIDANCE, THE CENTER MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE-LIKELY-THAN-NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, AND ACCOUNTING IN INTERIM PERIODS. 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 NO EXCEPTIONS, THE CORPORATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2007, 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 -85,453. PART XIII, LINE 4B - OTHER ADJUSTMENTS: PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -85,453. X X X 0 0 0 0 0 1 0 1 0 LINDSAY C FARRELL 236562 0 35000 0 524 0 8575 0 6356 0 287017 0 0 0 JANET H BOZZONE 182128 0 22334 0 688 0 7221 0 2333 0 214704 0 0 0 DAREN WU 215193 0 30999 0 163 0 8575 0 2041 0 256971 0 0 0 ASAF COHEN 143008 0 40658 0 93 0 6432 0 1955 0 192146 0 0 0 JYOTHI PARAPURATH 179984 0 0 0 140 0 2458 0 1431 0 184013 0 0 0 BRUNO CASANOVA 177776 0 0 0 140 0 2562 0 4635 0 185113 0 0 0 ANITA WILENKIN 171311 0 0 0 671 0 6295 0 12182 0 190459 0 0 0 THOMAS YUEN 156084 0 14006 0 116 0 6191 0 11220 0 187617 0 0 0 PART I, LINE 6 THE 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 12/31/10: DAREN WU - $30,999 JANET H. BOZZONE - $19,334 ASAF COHEN - $40,658 THOMAS YUEN - $14,006 PART I, LINE 7 THE FOLLOWING INDIVIDUALS, LISTED ON PART VII, RECEIVED NON-FIXED PAYMENTS, DETERMINED BY THE BOARD, DURING THE YEAR ENDED 12/31/10: LINDSAY C. FARRELL - $35,000 JANET H. BOZZONE - $3,000 X 1 25300 RETAIL VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 OPEN 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/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCE OFFICER REVIEW THE FORM 990 AND SCHEDULES FOR ACCURACY. IN MAY 2011, THE FORM 990 FOR THE YEAR ENDED DECEMBER 31, 2010 WAS PRESENTED TO THE FINANCE COMMITTEE AND BOARD MEMBERS FOR REVIEW PRIOR TO ITS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THROUGH 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 15 THE 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 19 OPEN 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 385,850. DONATED SERVICES AND USE OF FACILITIES: 143,047. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -85,453. TOTAL TO FORM 990, PART XI, LINE 5: 443,444. FORM 990, PART XII, LINE 2C: PROCESS HAS NOT CHANGED FROM PRIOR YEAR. # OF HOURS WORKED FOR RELATED ENTITIES FORM 990, PART VII LINDSAY FARRELL WORKED 3.8 HOURS/WEEK FOR OPEN DOOR FOUNDATION, INC. MARIA MAZZOTTA WORKED 1.8 HOURS/WEEK FOR OPEN DOOR FOUNDATION, INC. OPEN DOOR FOUNDATION INC 165 MAIN STREET OSSINING NY 10562 133598184 FUNDRAISING/DEVELOPMENT NY 501(C)(3) LINE 7 OPEN DOOR INC 0 OPEN DOOR INC 165 MAIN STREET OSSINING NY 10562 133585009 SUPPORTING ORGANIZATION NY 501(C)(3) LINE 11D, III-O 0 OPEN DOOR LEASING CORP 165 MAIN STREET OSSINING NY 10562 201726717 LEASING SPACE NY OPEN DOOR FAMILY MEDICAL CENTER INC C 251580 12000 1.00000 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 1 0 0 OPEN DOOR LEASING CORP J 230411 COST RELATED TAX EXEMPT ENTITY SCHEDULE R, PART II OPEN DOOR, INC. IS A TAX EXEMPT ORGANIZATION UNDERGOING A RETROACTIVE REINSTATEMENT OF ITS EXEMPT STATUS UNDER THE AUTOMATIC REVOCATION RULES IN PLACE IN THE INTERNAL REVENUE CODE.