2019-08-30T14:23:35-05:00 2018-12-31 221914888 NISIVOCCIA LLP 200 VALLEY RD SUITE 300 MT ARLINGTON NJ 07856 990 2018-01-01 223125397 ZUFALL HEALTH CENTER INC ZUFA 9733289100 18 WEST BLACKWELL ST DOVER NJ 07801 EVA TURBINER PRESIDENT & CEO 9733289100 2019-08-13 1 CHRIS PERROTTA CPA P01450368 9733281825 2019-08-13 69.74.239.98 2019-08-13 11:42:10 ED P 00391D0131DDC982E26CFEFC09860E696DD1CC6F 01531E7B676A3DAB4510CFD44FB7E9CEF9327574 2018 2019-02-21 02:37:17Z EVA TURBINER 17 SOUTH WARREN STREET WARREN NJ 07801 30291209 0 X WWW.ZUFALLHEALTH.ORG X 1991 NJ TO PROVIDE QUALITY, AFFORDABLE, AND CULTURALLY COMPETENT HEALTH CARE TO PEOPLE AND COMMUNITIES WHO EXPERIENCE BARRIERS TO CARE. 13 13 403 220 0 0 10126854 11562660 15475080 15982141 156714 118948 1555144 2187960 27313792 29851709 0 0 0 0 17410499 19425983 0 0 158729 8116754 9445018 25527253 28871001 1786539 980708 21573452 22940849 3554467 4282959 18018985 18657890 X TO PROVIDE QUALITY, AFFORDABLE, AND CULTURALLY COMPETENT HEALTH CARE TO PEOPLE AND COMMUNITIES WHO EXPERIENCE BARRIERS TO CARE. WITH THE GUIDANCE OF OUR CONSUMER BOARD AND THE EFFORTS OF OUR DEDICATED STAFF, WE OFFER ACCESS TO A BROAD ARRAY OF MEDICAL AND ENABLING SERVICES DESIGNED TO ELIMINATE HEALTH DISPARITIES AND TO IMPROVE THE QUALITY OF LIFE OF OUR COMMUNITY. 0 0 23491983 18170101 ZUFALL HEALTH CENTER PROVIDES MEDICAL, DENTAL & BEHAVIORAL HEALTH TO MORE THAN 39,000 UNINSURED AND UNDERINSURED PATIENTS AND MORE THAN 135,000 MEDICAL, DENTAL & BEHAVIORAL HEALTH VISITS TO LOW INCOME COMMUNITY RESIDENTS. ZUFALL HEALTH CENTER PROVIDED SPECIALLY TARGETED HEALTH CARE SERVICES TO THE HOMELESS, RESIDENTS OF PUBLIC HOUSING AND MIGRANT FARM WORKERS IN NORTHWEST NEW JERSEY. 23491983 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 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 0 0 0 0 1 174 0 1 403 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ X THE ORGANIZATION 9733289100 18 WEST BLACKWELL STREET DOVER NJ 07801 WILLIAM SHULER CHAIRMAN 1.00 X X 0 0 0 LINDA SEELEY SECRETARY 1.00 X X 0 0 0 DONALD COSTANZO VICE CHAIR 1.00 X X 0 0 0 ROBERT ZUFALL MD TRUSTEE 1.00 X 0 0 0 PAUL NUSBAUM TRUSTEE 1.00 X 0 0 0 XIOMARA GUEVARA TRUSTEE 1.00 X 0 0 0 IRMA MCKENNA TRUSTEE 1.00 X 0 0 0 RAUL AGUIRRE TRUSTEE 1.00 X 0 0 0 MARIA ANGARITA TRUSTEE 1.00 X 0 0 0 MICHAEL MCCLOE TRUSTEE 1.00 X 0 0 0 JUDY STEIN TRUSTEE 1.00 X 0 0 0 ANDREA RIOS TREASURER 1.00 X X 0 0 0 JOHN KRUEGER TRUSTEE 1.00 X 0 0 0 EVA TURBINER PRESIDENT & CEO 40.00 X 311280 0 15746 PETER BEBEL CFO 40.00 X 156741 0 14779 RINA RAMIREZ-ALEXANDER CMO 40.00 X 293798 0 8814 SAM WAKIM CDO 40.00 X 223251 0 13398 AMY KOTLER PHYSICIAN 40.00 X 160397 0 11641 DOUGLAS BISHOP PHYSICIAN 40.00 X 166831 0 15155 LILLIAN ZORILLA PHYSICIAN 40.00 X 161392 0 11540 BRIAN J WHANG CIO 40.00 X 159421 0 14871 1633111 0 105944 9 0 1 0 BENCO PO BOX 731372 DALLAS TX 75373 DENTAL SUPPLIES 618253 MCKESSON MEDICAL-SURGICAL INC PO BOX 634404 CINCINNATI OH 45263 MEDICAL SUPPLIES 382715 TOTAL MAINTENANCE SERVICES 1358 HOOPER AVE 136 TOMS RIVER NJ 08753 JANITORIAL SERVICES 277933 SOMERSET MEDICAL CENTER PO BOX 48026 NEWARK NJ 07101 SPECIALTY SERVICES 161055 ECLINICALWORKS LLC PO BOX 847950 BOSTON MA 02284 BILLING SOFTWARE 149921 5 5905958 5656702 1075928 11562660 NJ UNCOMPENSATED CARE 621400 5328101 5328101 MEDICAID 621400 3550682 3550682 NJ MANAGED CARE WRAPAROUND 621400 3490869 3490869 SELF-PAY 621400 2403896 2403896 PRIVATE INSURANCE 621400 683158 683158 525435 525435 15982141 88000 88000 470448 439500 30948 30948 30948 340B PHARMACY 621400 2187960 2187960 2187960 29851709 18170101 0 118948 1739055 1439895 288868 10292 14529706 12030239 2413474 85993 392446 324936 65188 2322 1461951 1210460 242838 8653 1302825 1078707 216407 7711 153562 153562 71683 71683 44150 44150 1878187 1126619 751128 440 495739 387153 106056 2530 581604 425513 125474 30617 250948 155262 95103 583 107555 107555 548476 449202 96532 2742 138038 113053 24295 690 CONSUMABLE SUPPLIES 3834734 3834734 OTHER 438786 273584 160826 4376 REPAIRS AND MAINTENANCE 413729 320088 92047 1594 EQUIPMENT RENTAL AND MA 287018 215671 71347 200809 106867 93756 186 28871001 23491983 5220289 158729 3208901 5687558 652377 867485 3987744 2467224 157873 156051 14553593 3535111 10569929 11018482 2926078 2673499 70550 70550 21573452 22940849 700671 800004 1844144 1677370 1009652 1805585 3554467 4282959 X 17382822 18442789 636163 215101 18018985 18657890 21573452 22940849 980708 -341803 0 X X 0 1 X 1 1 1 X 6782687 8057226 10306094 10126854 11562660 46835521 6782687 8057226 10306094 10126854 11562660 46835521 46835521 83165 74457 84960 85927 88000 416509 965616 1291657 1262485 1555144 2187960 7262862 54514892 59852963 0.85910 0.87130 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: 340B PHARMACY - 2014 AMOUNT: $ 965,616. 2015 AMOUNT: $ 1,291,657. 2016 AMOUNT: $ 1,262,485. 2017 AMOUNT: $ 1,555,144. 2018 AMOUNT: $ 2,187,960. 10308697 1479865 8828832 1965120 352454 1612666 1953894 1430692 523202 325882 272100 53782 11018482 ACCRUED PAYROLL AND EMPLOYEE BENEFITS 1170385 LINE OF CREDIT 635200 1805585 X 29509906 -341803 -341803 29851709 0 29851709 28871001 0 28871001 0 28871001 PART X, LINE 2: THE CENTER IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND CLASSIFIED BY THE INTERNAL REVENUE SERVICE AS OTHER THAN A PRIVATE FOUNDATION. THE CENTER IS ALSO EXEMPT UNDER TITLE 15 OF THE STATE OF NEW JERSEY CORPORATIONS AND ORGANIZATIONS NOT-FOR-PROFIT ACT. ACCORDINGLY, NO PROVISION FOR FEDERAL OR STATE INCOME TAX HAS BEEN PRESENTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE CENTER FOLLOWS THE PROVISIONS OF FASB ASC INCOME TAXES. THE STANDARD PRESCRIBES A MINIMUM RECOGNITION THRESHOLD AND MEASUREMENT METHODOLOGY THAT A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. IT ALSO PROVIDES GUIDANCE FOR DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION AS THEY RELATE TO THOSE TAX POSITIONS. THE CENTER BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR THE POSITIONS TAKEN ON ITS TAX RETURNS AND ACCORDINGLY, HAS NOT RECORDED ANY TAX PROVISION FOR THE YEAR ENDED DECEMBER 31, 2018. HOWEVER, THE CENTER IS SUBJECT TO AUDIT BY TAX AUTHORITIES INCLUDING A REVIEW OF ITS NONPROFIT STATUS WHICH MANAGEMENT BELIEVES WOULD BE UPHELD UPON EXAMINATION. AS SUCH, CERTAIN TAX POSITIONS COULD BE CHALLENGED AND THE AMOUNTS ULTIMATELY PAID, IF ANY, UPON RESOLUTION OF THE ISSUES RAISED BY THE TAXING AUTHORITIES, MAY DIFFER MATERIALLY FROM THE AMOUNTS FILED. AS REQUIRED BY LAW, THE CENTER FILES INFORMATIONAL RETURNS WITH BOTH THE UNITED STATES FEDERAL AND STATE OF NEW JERSEY JURISDICTIONS ON AN ANNUAL BASIS - FORM 990 WITH THE INTERNAL REVENUE SERVICE, AND FORM CRI-300R WITH THE STATE. THE CENTER IS SUBJECT TO EXAMINATIONS AT ANY TIME WITHIN CERTAIN STATUTORY PERIODS FROM THE LATEST FILING DATE FOR FEDERAL AND FOR NEW JERSEY. X X 0 0 0 0 0 0 0 1 0 EVA TURBINER PRESIDENT & CEO 311280 0 0 0 0 0 9323 0 6423 0 327026 0 0 0 PETER BEBEL CFO 156741 0 0 0 0 0 5104 0 9675 0 171520 0 0 0 RINA RAMIREZ-ALEXANDER CMO 293798 0 0 0 0 0 8814 0 0 0 302612 0 0 0 SAM WAKIM CDO 223251 0 0 0 0 0 6718 0 6680 0 236649 0 0 0 AMY KOTLER PHYSICIAN 160397 0 0 0 0 0 4961 0 6680 0 172038 0 0 0 DOUGLAS BISHOP PHYSICIAN 166831 0 0 0 0 0 5480 0 9675 0 181986 0 0 0 LILLIAN ZORILLA PHYSICIAN 161392 0 0 0 0 0 4860 0 6680 0 172932 0 0 0 BRIAN J WHANG CIO 159421 0 0 0 0 0 5196 0 9675 0 174292 0 0 0 PART I, LINE 7 INCLUDED ON PART II COLUMN B(II) ARE BONUS AMOUNTS. THESE AMOUNTS ARE APPROVED BY THE BOARD OF DIRECTORS AND INCLUDED IN THE INDIVIDUAL'S 2018 W-2'S. X 1 1075928 FMV 0 1 0 FORM 990, PART VI, SECTION A, LINE 2 PAUL NUSBAUM IS ROBERT ZUFALL'S ATTORNEY. WILLIAM SHULER IS EVA TURBINER'S AND ROBERT ZUFALL'S INSURANCE AGENT. FORM 990, PART VI, SECTION B, LINE 11B ZUFALL HEALTH CENTER, INC. 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 MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS PROVIDED TO THE MEMBERS OF THE ORGANIZATIONS GOVERNING BODY FOR ANY COMMENTS PRIOR TO ITS SUBMISSION. THE GOVERNING BODY IS PROVIDED WITH A REASONABLE AMOUNT OF TIME TO REVIEW THE FORM 990. ANY COMMENTS ARE THEN GROUPED, SUMMARIZED AND PROVIDED THROUGH MANAGEMENT TO THE OUTSIDE ACCOUNTING FIRM. ANY APPLICABLE ISSUES ARE ADDRESSED PRIOR TO THE RETURN BEING FINALIZED AND APPROVED FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C ZUFALL HEALTH CENTER, INC. CURRENTLY HAS IN PLACE A CONFLICT OF INTEREST POLICY WHICH IT REGULARLY MONITORS AND ENFORCES. THE BOARD MANDATES THAT ALL MEMBERS OF MANAGEMENT AND THE GOVERNING BODY ANNUALLY SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS THAT MAY EXIST. IF A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS, GOVERNING BODY AND MANAGEMENT WILL INVESTIGATE THE ISSUE. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, MANAGEMENT AND THE GOVERNING BODY WILL BE NOTIFIED IMMEDIATELY. THE MEMBER WILL NOT BE ALLOWED TO VOTE OR BE A PART OF ANY DECISIONS ABOUT ANY SUCH TRANSACTIONS THAT HAVE TO DO WITH THE CONFLICT UNTIL SUCH TIME THAT THERE IS NO LONGER A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION AT ZUFALL HEALTH CENTER TAKES INTO CONSIDERATION THE COMPENSATION PAID FOR OTHER SIMILAR POSITIONS IN THE MARKET PLACE AS WELL AS GENERAL PERFORMANCE OF THE EMPLOYEE AND THE CURRENT FINANCIAL CAPACITY OF THE ORGANIZATION. EACH YEAR THE BOARD OF DIRECTORS CONDUCTS A PERFORMANCE REVIEW OF THE CEO AND SETS THE CEO'S SALARY. WHEN ESTABLISHING THE SALARY THE BOARD REVIEWS COMPENSATION SURVEYS CONDUCTED BY THE NEW JERSEY PRIMARY CARE ASSOCIATION AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS TO ENSURE THAT ZUFALL CEO COMPENSATION IS KEEPING WITH STATE AND NATIONAL BENCHMARKS. SIMILARLY, THE CEO TAKES INTO ACCOUNT THOSE SAME COMPENSATION SURVEYS AS THE CEO SETS THE COMPENSATION FOR KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 ZUFALL HEALTH CENTER, INC. MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE UPON WRITTEN REQUEST AT THE ORGANIZATIONS OFFICE AT 18 WEST BLACKWELL STREET, DOVER, NJ, 07801. IN ADDITION FORM 1023 AS WELL AS THE FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON WRITTEN REQUEST AT THE ORGANIZATIONS OFFICE AT 18 WEST BLACKWELL STREET, DOVER, NJ, 07801. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT IS RESPONSIBLE FOR OVERVIEW OF THE AUDIT AS WELL AS THE SELECTION OF THE INDEPENDENT ACCOUNTANT. FORM 990, PART XII, LINE 3B THE ORGANIZATION IS REQUIRED TO FOLLOW THE AUDIT REQUIREMENTS OF TITLE 2 U.S. CODE OF FEDERAL REGULATIONS PART 200, UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS(UNIFORM GUIDANCE) WHICH SUPERCEDES OMB CIRCULAR A-133.