2019-10-28T13:17:49-05:00 2018-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2018-01-01 132739694 CHARLES B WANG COMMUNITY HEALTH CENTER INC CHAR 2123796988 268 CANAL STREET NEW YORK NY 10013 JANE T ENG PRESIDENT & CEO 2123796988 2019-10-25 1 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2019-10-02 209.59.242.22 2019-10-25 11:23:36 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 238159564A7F207AC3E2D33505B4833284B8AC6F 2018 2020-03-31 21:24:44Z JANE T ENG ESQ 268 CANAL STREET NEW YORK NY 10013 66623163 0 X WWW.CBWCHC.ORG X 1972 NY PROVIDE HIGH QUALITY AND AFFORDABLE HEALTH CARE TO THE UNDERSERVED, WITH A FOCUS ON ASIAN AMERICANS. 18 17 719 20 0 510745 11305626 9956616 50998159 51043741 233273 227435 3664723 3990292 66201781 65218084 0 0 0 0 47164099 48560513 0 0 0 14968267 14785101 62132366 63345614 4069415 1872470 68513006 70153796 13963543 14286971 54549463 55866825 PROVIDE HIGH QUALITY AND AFFORDABLE HEALTH CARE TO THE UNDERSERVED, WITH A FOCUS ON ASIAN AMERICANS. 0 0 54454127 55034033 THE ORGANIZATION OPERATED A FEDERALLY QUALIFIED HEALTH CENTER, WHICH HAD 279,703 VISITS IN 2018. 54454127 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 1 38 0 1 719 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X LYNN D SHERMAN 2123796988 268 CANAL STREET NEW YORK NY 10013 EMILY WOO BOARD MEMBER 2.00 X 0 0 0 IRENE CHU TREASURER 3.00 X X 0 0 0 JAMES WONG BOARD MEMBER 2.00 X 0 0 0 JEANNE LEE JACKSON BOARD MEMBER 2.00 X 0 0 0 JIMING LIANG VICE CHAIRPERSON 3.00 X X 0 0 0 KENNY CHIN ESQ BOARD MEMBER 2.00 X 0 0 0 LESLIE CHUANG MD BOARD MEMBER 2.00 X 0 0 0 MARIE LAM BOARD MEMBER 2.00 X 0 0 0 MARY AGNES PAN BOARD MEMBER 2.00 X 0 0 0 OWH KIAN ONG BOARD MEMBER 2.00 X 0 0 0 PAULINE TSE BOARD MEMBER 2.00 X 0 0 0 PHILIP CHONG JR BOARD MEMBER 2.00 X 0 0 0 ROBERT BELL BOARD MEMBER 2.00 X 0 0 0 SOPHIA TSAO SECRETARY 3.00 X X 0 0 0 STEPHANIE CHENG BOARD MEMBER 2.00 X 0 0 0 TIMOTHY HSU BOARD MEMBER 2.00 X 0 0 0 VICTOR LEE CHAIRPERSON 4.00 X X 0 0 0 WILLIAM TAM OUTGOING BOARD MEMBER 2.00 X 0 0 0 YVONNE GHAW BOARD MEMBER 2.00 X 0 0 0 BETTY K CHENG EXECUTIVE VP & COO 35.00 X 257556 0 44456 DE YOUNG CHAN CFO 35.00 X 186020 0 12537 JANE T ENG ESQ PRESIDENT & CEO 35.00 X 358860 0 44982 LYNN D SHERMAN EXECUTIVE VP, FINANCE, IT 35.00 X 291953 0 48532 PERRY PONG MD EXECUTIVE VP & CMO 35.00 X 306305 0 45727 REGINA F LEE ESQ EXECUTIVE VP PUBLIC AFFAIR 35.00 X 235317 0 44493 KENNETH SHIEH CHIEF STRATEGY OFFICER 35.00 X 196984 0 22750 ALLAN HO MD CHIEF OF OBSTETRICS AND GY 35.00 X 399244 0 48993 CHRISTINE J SHEN MD SENIOR PEDIATRICIAN 35.00 X 395381 0 36300 DU CHU WU MD SENIOR INTERNIST 35.00 X 363746 0 42874 JIE YING SHEN MD SENIOR PEDIATRICIAN 35.00 X 474108 0 38600 SHIMIN CAO MD CHIEF OF INTERNAL MEDICINE 35.00 X 339896 0 44181 3805370 0 474425 83 0 1 0 EDELMAN SULTAN KNOX WOOD ARCHITECTS LLP 100 LAFAYETTE STREET SUITE 204 NEW YORK NY 10013 ARCHITECTURAL SERVICES 1061649 RUSSO DEVELOPMENT ENTERPRISES INC 67 EAST AVENUE LAWRENCE NY 11559 DEMOLITION FEE 403353 FOX ROTHSCHILD LLP 2000 MARKET STREET20TH FLOOR PHILADELPHIA PA 19103 LEGAL SERVICES 261757 MATASSA CONSTRUCTIONINC 130 COMMERCIAL STREET PLAINVIEW NY 11803 CONSTRUCTION SERVICES 205198 VVC HOLDING CORP 40 IDX DRIVE SOUTH BURLINGTON VT 05403 EMR SERVICES 168916 9 7465738 2490878 2041149 9956616 NEW YORK STATE MEDICAID MANAGED C 621400 21044000 21044000 PRIVATE INSURANCE 621400 9695903 9695903 MEDICAID MANAGE CARE 621400 9146044 9146044 NEW YORK STATE UNCOMPENSATED 621400 4359275 4359275 MEDICAID 621400 3784316 3784316 3014203 3014203 51043741 241293 241293 1391221 1405079 -13858 -13858 -13858 HEALTH PLAN QUALITY DISTRIBUTION 900099 3349768 3349768 PATIENT METROCARD REIMBURSEMENT 900099 306053 306053 MANAGEMENT FEES 900099 264939 264939 69532 69532 3990292 65218084 55034033 0 227435 2096471 1798985 297486 37047691 31790678 5257013 1617731 1388177 229554 4936934 4236391 700543 2861686 2455617 406069 14289 14289 145524 145524 504849 399272 105577 615121 527836 87285 4139525 3545960 593565 312735 221535 91200 224956 159354 65602 1307294 1119842 187452 152279 49589 102690 DONATED VACCINES 2041149 2041149 PHARMACEUTICALS 2010276 2010276 CONSUMABLE SUPPLIES 1132475 1012480 119995 EQUIPMENT RENTAL AND MA 607644 339032 268612 1576985 1357954 219031 63345614 54454127 8891487 0 448812 385239 16256430 15509359 488791 606391 7223165 7845349 647149 572271 51039139 18095265 30815578 32943874 7124961 6753752 5508120 5537561 68513006 70153796 8315789 8765133 290000 200000 5357754 5321838 13963543 14286971 X 54289497 55856825 259966 10000 54549463 55866825 68513006 70153796 1872470 -555108 0 X X 0 1 X 1 1 1 X 7989685 11801408 9296250 11305626 9956616 50349585 41220402 41847842 44047545 50998159 51043741 229157689 49210087 53649250 53343795 62303785 61000357 279507274 25000 45000 134130 204130 0 25000 45000 134130 204130 279303144 154698 322058 190132 196358 241293 1104539 154698 322058 190132 196358 241293 1104539 3134268 3411026 3601478 3664723 3990292 17801787 52499053 57382334 57135405 66164866 65231942 298413600 0.93600 0.94700 0.00370 0.00310 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: HEALTH PLAN QUALITY DISTRIBUTION - 2014 AMOUNT: $ 1,957,315. 2015 AMOUNT: $ 2,337,220. 2016 AMOUNT: $ 2,728,821. 2017 AMOUNT: $ 2,796,726. 2018 AMOUNT: $ 3,349,768. MEANINGFUL USE INCENTIVE - 2014 AMOUNT: $ 463,250. 2015 AMOUNT: $ 416,500. 2016 AMOUNT: $ 242,250. 2017 AMOUNT: $ 212,500. MANAGEMENT SERVICES FEES - 2014 AMOUNT: $ 238,555. 2015 AMOUNT: $ 243,654. 2016 AMOUNT: $ 250,573. 2017 AMOUNT: $ 259,436. 2018 AMOUNT: $ 264,939. METROCARD REIMBURSEMENT - 2014 AMOUNT: $ 239,803. 2015 AMOUNT: $ 364,095. 2016 AMOUNT: $ 316,674. 2017 AMOUNT: $ 319,091. 2018 AMOUNT: $ 306,053. MEDICAL RECORDS CHARGES - 2014 AMOUNT: $ 27,520. 2015 AMOUNT: $ 37,457. 2016 AMOUNT: $ 42,103. 2017 AMOUNT: $ 45,559. 2018 AMOUNT: $ 54,190. OTHER - 2014 AMOUNT: $ 207,825. 2015 AMOUNT: $ 12,100. 2016 AMOUNT: $ 21,057. 2017 AMOUNT: $ 31,411. 2018 AMOUNT: $ 15,342. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14958494 14958494 20942000 9315545 11626455 9748742 8779720 969022 5389903 5389903 32943874 SECURITY DEPOSITS 678563 DEFERRED COMPENSATION ACCOUNT 4858998 5537561 DEFERRED COMPENSATION PAYABLE 4858998 DEFERRED RENT 462840 5321838 X 64666906 -555108 3930 -551178 65218084 0 65218084 63349544 3930 3930 63345614 0 63345614 PART X, LINE 2: THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2018. THE CENTER'S FEDERAL AND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2015 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE CENTER RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS OPERATING EXPENSES AND INCLUDES ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE STATEMENT OF FINANCIAL POSITION. X X X X 0 0 0 0 0 0 0 0 0 BETTY K CHENG EXECUTIVE VP & COO 237341 0 0 0 20215 0 15362 0 29094 0 302012 0 0 0 DE YOUNG CHAN CFO 184988 0 0 0 1032 0 11099 0 1437 0 198556 0 0 0 JANE T ENG ESQ PRESIDENT & CEO 331749 0 6896 0 20215 0 16500 0 28482 0 403842 0 0 0 LYNN D SHERMAN EXECUTIVE VP, FINANCE, IT 271869 0 0 0 20084 0 16500 0 32032 0 340485 0 0 0 PERRY PONG MD EXECUTIVE VP & CMO 305273 0 0 0 1032 0 16500 0 29227 0 352032 0 0 0 REGINA F LEE ESQ EXECUTIVE VP PUBLIC AFFAIR 215102 0 0 0 20215 0 14384 0 30109 0 279810 0 0 0 KENNETH SHIEH CHIEF STRATEGY OFFICER 196744 0 0 0 240 0 12384 0 10366 0 219734 0 0 0 ALLAN HO MD CHIEF OF OBSTETRICS AND GY 379712 0 0 0 19532 0 16500 0 32433 0 448177 0 0 0 CHRISTINE J SHEN MD SENIOR PEDIATRICIAN 376329 0 0 0 19052 0 8798 0 27502 0 431681 0 0 0 DU CHU WU MD SENIOR INTERNIST 344214 0 0 0 19532 0 12266 0 30607 0 406619 0 0 0 JIE YING SHEN MD SENIOR PEDIATRICIAN 454576 0 0 0 19532 0 9538 0 29062 0 512708 0 0 0 SHIMIN CAO MD CHIEF OF INTERNAL MEDICINE 338864 0 0 0 1032 0 13979 0 30202 0 384077 0 0 0 SCHEDULE J, PART II: A PORTION OF THE AMOUNT PRESENTED IN COLUMN B(III) FOR ALLAN HO, CHRISTINE J. SHEN, JIE YING SHEN, REGINA F. LEE, BETTY K. CHENG, JANE T. ENG, DU CHU WU, AND LYNN D. SHERMAN REPRESENT AMOUNTS DEFERRED INTO A QUALIFIED RETIREMENT PLAN. CENTRE COURT HOLDINGS LLC IRENE CHU, BOARD MEMBER, HAS FINANCIAL INTEREST IN CENTRE COURT HLDNGS LLC 424872 RENT 0 X 1 2041149 FMV 0 0 0 PART I, COLUMN (B): COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B COPIES OF THE FORM 990 ARE DISTRIBUTED THE BOARD OF DIRECTORS. IT IS REVIEWED BY SENIOR MANAGEMENT, INCLUDING THE CEO AND CFO, AND THE BOARD AUDIT COMMITTEE, WHO PRESENT IT TO THE BOARD OF DIRECTORS FOR A VOTE BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S DIRECTORS, OFFICERS AND KEY EMPLOYEES SIGN DISCLOSURE STATEMENTS ANNUALLY. THE BOARD DEVELOPMENT COMMITTEE AND AUDIT COMMITTEE ARE RESPONSIBLE FOR MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IN THE EVENT A CONFLICT EXISTS, THE INDIVIDUAL WITH THE CONFLICT MUST RECUSE HIMSELF/HERSELF FROM ANY DELIBERATION AND VOTING REGARDING THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A ANNUALLY, THE COMPENSATION COMMITTEE OF THE BOARD REVIEWS AND EVALUATES THE PRESIDENT AND CEO AND DECIDES ON COMPENSATION. INFORMATION FROM OUTSIDE CONSULTANTS ON COMPARABLE SALARIES OF SIMILAR ORGANIZATIONS MAY BE USED IN THEIR DETERMINATION. SALARIES FOR OTHER OFFICERS & KEY EMPLOYEES ARE DETERMINED BY THE PRESIDENT AND CEO, USING SALARY SURVEYS WITH INFORMATION FROM OTHER HEALTH CENTERS, AS WELL AS EMPLOYEE ANNUAL EVALUATIONS. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR PERIOD PROCESS. HEALTHVIEW CBWCHC INC 268 CANAL STREET NEW YORK NY 10013 822560880 PROVIDE SUPPORT TO CHARLES B. WANG COMMUNITY HEALTH CENTER, INC. NY 501(C)(3) LINE 12A, I CHARLES B WANG COMMUNITY HEALTH CENTER INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0