2021-11-04T16:12:30-05:00 2020-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2020-01-01 132739694 CHARLES B WANG COMMUNITY HEALTH CENTER INC CHAR 2123796988 268 CANAL STREET NEW YORK NY 10013 KAUSHAL CHALLA CEO 2123796988 2021-10-29 1 KAUSHAL CHALLA 999009999 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2021-10-13 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z KAUSHAL CHALLA 268 CANAL STREET NEW YORK NY 10013 63071350 0 X WWW.CBWCHC.ORG X 1972 NY PROVIDE HIGH QUALITY AND AFFORDABLE HEALTH CARE TO THE UNDERSERVED, WITH A FOCUS ON ASIAN AMERICANS. 17 16 645 20 0 0 23642686 14437767 49091404 41021157 1008391 1316195 4027809 3709740 77770290 60484859 29942664 0 0 0 52375997 45186342 0 0 0 15033768 13438553 97352429 58624895 -19582139 1859964 50711571 53115826 14110331 15717126 36601240 37398700 PROVIDE HIGH QUALITY AND AFFORDABLE HEALTH CARE TO THE UNDERSERVED, WITH A FOCUS ON ASIAN AMERICANS. 0 0 49820421 44730897 THE ORGANIZATION OPERATED A FEDERALLY QUALIFIED HEALTH CENTER, WHICH HAD 225,152 VISITS IN 2020. 49820421 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0 0 0 1 1 0 0 0 1 14 0 1 645 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 16 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 BOARD MEMBER 2.00 X 0 0 0 JEANNE LEE JACKSON BOARD MEMBER 2.00 X 0 0 0 JIMING LIANG CHAIRPERSON 3.00 1.00 X X 0 0 0 KENNY CHIN ESQ OUTGOING BOARD MEMBER 2.00 X 0 0 0 KITTY CHEN BOARD MEMBER 2.00 X 0 0 0 LESLIE CHUANG MD BOARD MEMBER 2.00 X 0 0 0 LINH MY AN BOARD MEMBER 2.00 X 0 0 0 MARIE LAM OUTGOING BOARD MEMBER 2.00 1.00 X 0 0 0 MARY AGNES PAN TREASURER 3.00 X X 0 0 0 OWH KIAN ONG VICE-CHAIRPERSON 3.00 X 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 REGINA LEE BOARD MEMBER 2.00 X 0 0 0 SOPHIA NG TSAO BOARD MEMBER 2.00 X 0 0 0 STEPHANIE CHENG SECRETARY 3.00 X X 0 0 0 TIMOTHY HSU OUTGOING BOARD MEMBER 2.00 X 0 0 0 VICKI TSE MD BOARD MEMBER 2.00 X 0 0 0 VICTOR LEE BOARD MEMBER 2.00 1.00 X 0 0 0 YVONNE GHAW BOARD MEMBER 2.00 X 0 0 0 BETTY K CHENG EXECUTIVE VP & COO 35.00 X 274287 0 44487 DE YOUNG CHAN CFO 35.00 X 198227 0 17306 JANE T ENG ESQ OUTGOING PRESIDENT & CEO 34.00 1.00 X 239183 0 13900 KAUSHAL CHALLA CHIEF EXECUTIVE OFFICER 34.00 1.00 X 334794 0 647 KENNETH SHIEH CHIEF STRATEGY OFFICER 35.00 X 213945 0 20229 LYNN D SHERMAN EVP FINANCE , IT, CAPITAL PROJECTS & HUMAN RESOURC 34.00 1.00 X 318790 0 45841 PERRY PONG MD EXECUTIVE VP & CMO 35.00 X 327571 0 44341 ALLAN W HO MD CHIEF OF OBSTETRICS AND GYNECOLOGY 35.00 X 368499 0 42568 DU CHU WU MD SENIOR INTERNIST LEVEL II 35.00 X 312292 0 40374 JIAN-PING CHEN MD DIRECTOR OF MENTAL HEALTH 35.00 X 348803 0 43331 JIE YING SHEN MD SENIOR PEDIATRICIAN LEVEL II 35.00 X 376171 0 36190 SHIMIN CAO MD CHIEF OF INTERNAL MEDICINE, QUEENS 35.00 X 325899 0 42108 3638461 0 391322 12 0 1 0 VVC HOLDING CORP 95 PINE ST STE110 BURLINGTON VT 05401 EMR SERVICES 223776 AFRICAN SERVICES COMMITTEE INC 429 WEST 127TH ST NEW YORK NY 10027 HEP B SCREENING AND EDUCATION 154486 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS 7TH FL NEW YORK NY 10019 AUDIT/TAX SERVICES 121985 CIPHERHEALTH ONE PENN PLAZA STE 3101 NEW YORK NY 10119 APPOINTMENT REMINDERS/BROADCAST MESSAGIN 120000 4 12270774 2166993 1562234 14437767 NEW YORK STATE MEDICAID MANAGED C 621400 15951000 15951000 MANAGED CARE PLANS 621400 9298600 9298600 PRIVATE INSURANCE 621400 7566640 7566640 NEW YORK STATE UNCOMPENSATED CARE 621400 3406286 3406286 MEDICAID 621400 2849768 2849768 1948863 1948863 41021157 115181 115181 3787505 2586491 1201014 1201014 1201014 HEALTH PLAN QUALITY DISTRIBUTION 900099 3244295 3244295 MANAGEMENT SERVICES FEES 900099 257532 257532 METROCARD REIMBURSEMENT 900099 107899 107899 100014 100014 3709740 60484859 44730897 0 1316195 2093575 1790594 302981 31292356 26763731 4528625 1361737 1164666 197071 6255898 5350546 905352 4182776 3577446 605330 70436 70436 137565 137565 1013177 479410 533767 591502 505900 85602 4160792 3569596 591196 102936 74866 28070 67320 48963 18357 1247491 1070238 177253 166643 54358 112285 PHARMACEUTICALS 1663051 1663051 DONATED VACCINES 1559834 1559834 CONSUMABLE SUPPLIES 962560 875945 86615 EQUIPMENT RENTAL AND MA 542874 457108 85766 1152372 814169 338203 58624895 49820421 8804474 0 458084 631547 17470386 19880184 2308214 1829985 6869085 6841377 759032 498583 31377710 20692472 11779858 10685238 4639966 4814402 6426946 7934510 50711571 53115826 7754564 8316235 6355767 7400891 14110331 15717126 X 34712491 35665367 1888749 1733333 36601240 37398700 50711571 53115826 1859964 -1062504 0 X X 0 1 X 1 1 1 X 9296250 11305626 9956616 23642685 14437767 68638944 44047545 50998159 51043741 49091404 41021157 236202006 53343795 62303785 61000357 72734089 55458924 304840950 45000 134130 546000 30020 755150 0 45000 134130 546000 30020 755150 304085800 190132 196358 241293 249235 115181 992199 190132 196358 241293 249235 115181 992199 3601478 3664723 3990292 4027809 3709740 18994042 57135405 66164866 65231942 77011133 59283845 324827191 0.93610 0.93610 0.00310 0.00370 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: HEALTH PLAN QUALITY DISTRIBUTION - 2016 AMOUNT: $ 2,728,821. 2017 AMOUNT: $ 2,796,726. 2018 AMOUNT: $ 3,349,768. 2019 AMOUNT: $ 3,269,299. 2020 AMOUNT: $ 3,244,295. MEANINGFUL USE INCENTIVE - 2016 AMOUNT: $ 242,250. 2017 AMOUNT: $ 212,500. MANAGEMENT SERVICES FEES - 2016 AMOUNT: $ 250,573. 2017 AMOUNT: $ 259,436. 2018 AMOUNT: $ 264,939. 2019 AMOUNT: $ 238,903. 2020 AMOUNT: $ 257,532. METROCARD REIMBURSEMENT - 2016 AMOUNT: $ 316,674. 2017 AMOUNT: $ 319,091. 2018 AMOUNT: $ 306,053. 2019 AMOUNT: $ 277,343. 2020 AMOUNT: $ 107,899. MEDICAL RECORDS CHARGES - 2016 AMOUNT: $ 42,103. 2017 AMOUNT: $ 45,559. 2018 AMOUNT: $ 54,190. 2019 AMOUNT: $ 62,910. 2020 AMOUNT: $ 40,454. OTHER - 2016 AMOUNT: $ 21,057. 2017 AMOUNT: $ 31,411. 2018 AMOUNT: $ 15,342. 2019 AMOUNT: $ 179,354. 2020 AMOUNT: $ 59,560. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21013357 10684493 10328864 10364353 10007979 356374 10685238 SECURITY DEPOSITS 880535 DEFERRED COMPENSATION ACCOUNT 7053975 7934510 DEFERRED COMPENSATION PAYABLE 7053975 DEFERRED RENT 346916 7400891 X 59606272 -1062504 183917 -878587 60484859 0 60484859 59039923 415028 415028 58624895 0 58624895 PART X, LINE 2: THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2020. THE CENTER'S FEDERAL AND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2017 ARE CLOSED, AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE CENTER RECOGNIZE 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION REVENUE 183,917. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION EXPENSES 415,028. PART XII, LINE 4B - OTHER ADJUSTMENTS: DONATIONS TO HEALTHVIEW CBWCHC INC X X X X 0 0 0 0 0 0 0 0 0 JIE YING SHEN MD SENIOR PEDIATRICIAN LEVEL II 375139 0 0 0 1032 0 8749 0 27441 0 412361 0 0 0 ALLAN W HO MD CHIEF OF OBSTETRICS AND GYNECOLOGY 367467 0 0 0 1032 0 17100 0 25468 0 411067 0 0 0 JIAN-PING CHEN MD DIRECTOR OF MENTAL HEALTH 347771 0 0 0 1032 0 17100 0 26231 0 392134 0 0 0 PERRY PONG MD EXECUTIVE VP & CMO 326539 0 0 0 1032 0 17100 0 27241 0 371912 0 0 0 SHIMIN CAO MD CHIEF OF INTERNAL MEDICINE, QUEENS 324315 0 0 0 1584 0 14077 0 28031 0 368007 0 0 0 LYNN D SHERMAN EVP FINANCE , IT, CAPITAL PROJECTS & 317206 0 0 0 1584 0 17100 0 28741 0 364631 0 0 0 DU CHU WU MD SENIOR INTERNIST LEVEL II 311260 0 0 0 1032 0 10903 0 29471 0 352666 0 0 0 KAUSHAL CHALLA CHIEF EXECUTIVE OFFICER 334650 0 0 0 144 0 0 0 647 0 335441 0 0 0 BETTY K CHENG EXECUTIVE VP & COO 272572 0 0 0 1715 0 16614 0 27873 0 318774 0 0 0 JANE T ENG ESQ OUTGOING PRESIDENT & CEO 238460 0 0 0 723 0 0 0 13900 0 253083 0 0 0 KENNETH SHIEH CHIEF STRATEGY OFFICER 213585 0 0 0 360 0 13138 0 7091 0 234174 0 0 0 DE YOUNG CHAN CFO 197195 0 0 0 1032 0 12004 0 5302 0 215533 0 0 0 CENTRE COURT HOLDINGS LLC IRENE CHU, BOARD MEMBER, HAS FINANCIAL INTEREST IN CENTRE COURT HLDNGS LLC 450744 RENT 0 X 2 1562234 FMV 0 0 0 PART I, COLUMN (B): COLUMN B REPRESENTS 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 DISTRIBUTED TO THE BOARD OF DIRECTORS 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0