2021-09-03T09:11:01-05:00 2020-12-31 042571780 AAFCPAS INC 50 WASHINGTON STREET WESTBOROUGH MA 01581 990 2020-01-01 050368134 THE PROVIDENCE COMMUNITY HEALTH CENTERS INC PROV 4014440400 375 ALLENS AVENUE PROVIDENCE RI 029055010 MERRILL THOMAS CHIEF EXECUTIVE OFFICER 4014440400 2021-09-02 1 MERRILL THOMAS XXX-XX-XXXX CHARLES J WEBB CPA P01584539 5083669100 2021-09-02 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MERRILL THOMAS 375 ALLENS AVENUE PROVIDENCE RI 02905 84097189 0 X WWW.PROVIDENCECHC.ORG X 1976 RI PROVIDE NEIGHBORHOOD-BASED HIGH QUALITY AND ACCESSIBLE PRIMARY MEDICAL CARE TO IMPROVE THE HEALTH STATUS OF THE RESIDENTS OF PROVIDENCE AND SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. 12 12 663 12 0 0 12742364 20367282 61572973 59583126 618579 403089 572657 2118079 75506573 82471576 0 0 0 0 48710075 52775051 0 0 0 19310049 25481937 68020124 78256988 7486449 4214588 76653344 81139584 24708757 28850918 51944587 52288666 PROVIDE NEIGHBORHOOD-BASED HIGH QUALITY AND ACCESSIBLE PRIMARY MEDICAL CARE TO IMPROVE THE HEALTH STATUS OF THE RESIDENTS OF PROVIDENCE AND SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. 0 0 47773125 45771504 PATIENT SERVICEPROVISION OF PRIMARY HEALTH CARE TO RESIDENTS IN PROVIDENCE ALSO PROVIDING DENTAL, PHARMACY, AND SPECIALIZED CARE AT 10 SITES IN PROVIDENCE. IN FY20 SERVED OVER 56,800 PATIENTS WITH OVER 273,621 PATIENT VISITS. 5016224 4083443 DENTALPCHC DENTAL OFFERS COMPREHENSIVE DENTAL CARE INCLUDING: EXAMINATIONS, RADIOGRAPHS, CLEANINGS, FLUORIDE TREATMENTS, SEALANTS, FILLINGS AND EXTRACTIONS. PCHC DENTAL CLINIC PROVIDES DENTAL SERVICES TO CHILDREN UNDER THE AGE OF 19 AND PREGNANT WOMEN; ADULT SERVICES INCLUDE PREVENTATIVE AND RESTORATIVE TREATMENTS. IN FY20 SERVED 6,579 PATIENTS WITH 12,042 PATIENT VISITS. 6212125 11846258 PHARMACY - 340B340B PROGRAM IS ESSENTIAL TO HELPING PROVIDERS STRETCH LIMITED RESOURCES TO BETTER SERVE VULNERABLE COMMUNITIES AND TO MANAGE RISING PRESCRIPTION DRUG COSTS. 340B CONTRACTS WITH WALMART, CVS, WALGREENS, AND OTHER LOCAL PHARMACIES TO PROVIDE PRESCRIPTIONS AT REDUCED PRICING TO PCHC PATIENTS. IN FY20 THERE WERE 42,793 PATIENTS UTILIZING CONTRACT PHARMACY AND 327,170 PRESCRIPTIONS SENT TO CONTRACT PHARMACY. 59001474 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 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 65 0 1 663 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 RI X KEVIN CABRAL CHIEF FINANCIAL OFFIC 4014440400 375 ALLENS AVENUE PROVIDENCE RI 02905 DILEK CERMIK MD OB/GYN 35.00 X 498619 0 30006 MERRILL R THOMAS CEO 40.00 X 500165 0 26646 ANDREW D SAAL VP AND CMO 40.00 X 394732 0 26850 ALTUG KOYMEN MD OB/GYN 35.00 X 310094 0 27804 EMILY WHITE MD OB/GYN 35.00 X 309899 0 25824 STANLEY H BLOCK EMERITUS CMO 35.00 X 300649 0 28135 JESSICA SALAK MD OB/GYN 35.00 X 245463 0 17809 GREGORY YOUNG VP & CFO (UNTIL 7/10/20) 40.00 X 219103 0 15546 KEVIN CABRAL ASSOCIATE VP FINANCE (AS OF 7/13/20) 40.00 X 87500 0 7811 ELENA NICOLELLA BOARD CHAIR 1.00 X X 0 0 0 CARL BROWN VICE CHAIR 1.00 X X 0 0 0 AMBER AUBIN BOARD TREASURER 1.00 X X 0 0 0 CASSANDRA L FEENEY BOARD SECRETARY 1.00 X X 0 0 0 MICHAEL CANCILLIERE BOARD MEMBER 1.00 X 0 0 0 EMILLIAN EGBUCHE BOARD MEMBER 1.00 X 0 0 0 WENDY THOMAS BOARD MEMBER 1.00 X 0 0 0 DR LUISA F CALACALA BOARD MEMBER 1.00 X 0 0 0 PATRICIA CHIVERS BOARD MEMBER 1.00 X 0 0 0 MARY FRANCIS BISHOP BOARD MEMBER 1.00 X 0 0 0 CHRISTINA ZANFAGNA BOARD MEMBER 1.00 X 0 0 0 MICHELLE ROSARIO BOARD MEMBER 1.00 X 0 0 0 DOMI ORTIZ BOARD MEMBER (UNTIL 10/2020) 1.00 X 0 0 0 DR GLENN RAWSON BOARD MEMBER (UNTIL 3/2020) 1.00 X 0 0 0 2866224 0 206431 89 0 1 0 PAR80 INC 170 MILK STREET FLOOR 2 BOSTON MA 02109 PHARMACY CONSULTANTS 346902 CASE CONSTRUCTION CO 225 WAMPANOAG TRL RIVERSIDE RI 02915 CONSTRUCTION CONTRACTOR 275453 MAXIM HEALTHCARE SERVICES INC 1 CEDAR STREET PROVIDENCE RI 02903 EMPLOYMENT AGENCY 162100 JVT ADVISORS 35 NEW ENGLAND BUSINESS CENTER ANDOVER MA 01810 RECRUITMENT AGENCY 138934 CERVENKA GREEN DUCHARME 235 PROMENADE STREET SUITE 475 PROVIDENCE RI 02908 LEGAL SERVICES 121520 7 8023449 12343833 20367282 PATIENT SERVICE REVENUE 621110 59583126 59583126 59583126 360721 360721 1667981 1625613 42368 42368 42368 RENTAL INCOME 900002 1727624 1727624 MISCELLANEOUS 621110 390455 390455 2118079 82471576 61701205 0 403089 1278352 84316 1194036 40636689 33290599 7346090 1609564 1277087 332477 6517599 5135888 1381711 2732847 2138020 594827 24100 24100 323236 323236 165541 165541 2211783 1167290 1044493 62667 62667 669854 422281 247573 4001763 3143861 857902 179348 18411 160937 694940 383133 311807 1655501 1259582 395919 489784 361726 128058 MEDICAL SUPPLIES AND SE 4718807 4718807 LOSS ON INVESTMENT IN A 3498365 3498365 DATA PROCESSING 2422817 2005365 417452 LICENSES & FEES 2337979 2337979 2025452 1257129 768323 78256988 59001474 19255514 0 9725839 11167806 136652 4060271 12447477 11165788 968685 9908177 519121 825018 1037004 56164166 16542437 32272786 39621729 6319563 6702356 3498365 1519467 5896824 76653344 81139584 4957317 6383378 9349276 8982668 9045697 9877468 1356467 3607404 24708757 28850918 X 51594587 51761639 350000 527027 51944587 52288666 76653344 81139584 X 4214588 160366 -4030875 X X 0 1 X 1 1 1 X 7997796 10335851 9862370 12742364 20367282 61305663 7997796 10335851 9862370 12742364 20367282 61305663 61305663 592552 596517 620892 621856 360721 2792538 142357 128365 148355 522228 2118079 3059384 67157585 257477889 0.91290 0.92550 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4438723 4438723 43358592 9440528 33918064 8220587 6984574 1236013 146264 117335 28929 39621729 CONSTRUCTION IN PROCESS 3703007 DUE FROM AFFILIATES 154571 RESTRICTED CASH 1372343 DEFERRED RENTAL REVENUE 354653 SECURITY DEPOSIT 312250 5896824 DEFERRED LEASE PAYABLE 1589148 ACCUMULATED UNREALIZED LOSS ON INTEREST RATE SWAP CONTRACT 1568256 PREPAID RENT 450000 3607404 X PART X, LINE 2: THE HEALTH CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES IN ACCORDANCE WITH ASC TOPIC, INCOME TAXES. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE CONSOLIDATING FINANCIAL STATEMENTS REGARDING A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE HEALTH CENTER HAS DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS WHICH QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE. X X 0 0 0 0 0 0 0 0 0 DILEK CERMIK MD OB/GYN 217222 0 281397 0 0 0 6856 0 23150 0 528625 0 0 0 MERRILL R THOMAS CEO 442540 0 57625 0 0 0 10110 0 16536 0 526811 0 0 0 ANDREW D SAAL VP AND CMO 352076 0 42656 0 0 0 3700 0 23150 0 421582 0 0 0 ALTUG KOYMEN MD OB/GYN 254482 0 55612 0 0 0 11268 0 16536 0 337898 0 0 0 EMILY WHITE MD OB/GYN 214121 0 95778 0 0 0 9288 0 16536 0 335723 0 0 0 STANLEY H BLOCK EMERITUS CMO 287041 0 13608 0 0 0 19867 0 8268 0 328784 0 0 0 JESSICA SALAK MD OB/GYN 204619 0 40844 0 0 0 9541 0 8268 0 263272 0 0 0 GREGORY YOUNG VP & CFO (UNTIL 7/10/20) 189978 0 29125 0 0 0 5923 0 9623 0 234649 0 0 0 KEVIN CABRAL ASSOCIATE VP FINANCE (AS OF 7/13/20) 74650 0 12850 0 0 0 4038 0 3773 0 95311 0 0 0 A RHODE ISLAND HEALTH AND EDUCATION BUILDING CORPORATION 521300173 2010-12-23 12115000 TO CONSTRUCT NEW FACILITIES AND PAY DOWN EXISTING DEBT. 0 0 0 A 3132332 12115000 242300 11872700 2011 0 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 CITIZENS BANK 2.245000000000 0 0 0 0 1 A 1 MERRILL THOMAS PRESIDENT & CEO SPLIT-DOLLAR LIFE INSURANCE PLAN X 968685 968685 0 1 1 968685 MERRILL THOMAS CEO 18837790 BOARD MEMBER OF FUNDING SOURCE. THE CEO OF THE HEALTH CENTER SERVES ON THE BOARD OF DIRECTORS OF NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND, WHICH PROVIDES THIRD PARTY REVENUE TO THE HEALTH CENTER. 0 MERRILL THOMAS CEO 1653462 BOARD MEMBER OF VENDOR. THE CEO OF THE HEALTH CENTER SERVES ON THE BOD OF HCN, WHICH PROVIDES TECHNOLOGY SOLUTIONS TO THE HEALTH CENTER. 0 FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY MANAGEMENT AND A COPY IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C PROVIDENCE COMMUNITY HEALTH CENTERS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REVIEWING THE POLICY ANNUALLY AT THE ANNUAL BOARD OF DIRECTORS MEETING, VERIFYING THAT ALL MANAGEMENT AND BOARD MEMBERS HAVE FILLED OUT THE CONFLICT OF INTEREST FORMS AND ARE FOLLOWING THE SPECIFIED GUIDELINES. FORM 990, PART VI, SECTION B, LINE 15 PROVIDENCE COMMUNITY HEALTH CENTERS UTILIZES THE BOARD OF DIRECTORS TO REVIEW AND DETERMINE THE CHIEF EXECUTIVE OFFICER'S SALARY. THE BOARD OF DIRECTORS THEN VOTES FOR APPROVAL ONCE THE SALARY AMOUNT IS DETERMINED. COMPENSATION FOR HOURLY NON-EXEMPT AND SALARIED EXEMPT EMPLOYEES ARE DETERMINED BASED UPON THE RESULTS OF BARGAINING UNIT NEGOTIATIONS. FORM 990, PART VI, SECTION C, LINE 19 PROVIDENCE COMMUNITY HEALTH CENTERS MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: UNREALIZED LOSS ON CARRYING VALUE OF INTEREST RATE SWAP -491,830. NET GAIN ON NMTC UNWIND -2,322,311. NET ASSET TRANSFER -1,216,734. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PCHC BEAMAN AND SMITH MILL MASTER TENANT LLC 375 ALLENS AVE PROVIDENCE RI 02905 461430610 TO LEASE PROPERTY FROM PCHC BEAMAN AND SMITH MILL, LLC. RI 24744 531186 THE PROVIDENCE COMMUNITY HEALTH CENTERS INC PCHC BEAMAN AND SMITH MILL LLC 375 ALLENS AVENUE PROVIDENCE RI 02905 800858375 TO HOLD AND DEVELOP REAL ESTATE. RI B&S MILL INC EXCLUDED 512-514 -3151 232271 0 0 0.01000 B&S MILL INC 375 ALLENS AVENUE PROVIDENCE RI 02905 461527210 TO SERVE AS THE MANAGER OF PCHC B&S MILL, LLC AND PCHC B&S MILL MT, LLC RI THE PROVIDENCE COMMUNITY HEALTH CENTERS INC C 1.00000 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 PCHC BEAMAN AND SMITH MILL MT LLC K 740011 RENTAL INCOME