2021-10-08T09:10:15-05:00 2020-12-31 221478099 COHNREZNICK LLP 14 SYLVAN WAY PARSIPPANY NJ 070543801 990 2020-01-01 132813103 OPEN DOOR FAMILY MEDICAL CENTER INC OPEN 9145021470 165 MAIN STREET OSSINING NY 10562 LINDSAY C FARRELL PRESIDENT & CEO 9145021470 2021-11-15 1 LINDSAY FARRELL 999009999 LORI ROTHE YOKOBOSKY CPA P01273422 9732283500 2021-10-01 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z LINDSAY C FARRELL 165 MAIN STREET OSSINING NY 10562 74027910 0 X WWW.OPENDOORMEDICAL.ORG X 1975 NY OPEN DOOR FAMILY MEDICAL CENTER PROVIDES 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. 13 13 718 14 220252 0 12879694 23483218 38478456 40526891 2157265 2777602 4101501 2890174 57616916 69677885 0 0 0 0 42321805 41255319 0 0 0 17706711 16741969 60028516 57997288 -2411600 11680597 125209024 144638316 11342072 11501595 113866952 133136721 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 40279978 31710805 OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 59,677 MEDICAL PATIENTS THAT GENDERATED 177,642 VISITS IN 2020.ADDITIONAL FUNDING FOR THIS PROGRAM IS PROVIDED THROUGH FEDERAL GRANTS, AS SHOWN ON FORM 990, PART VIII, LINE 1E. 5479945 6246087 OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 15,388 DENTAL PATIENTS THAT GENDERATED 31,067 VISITS IN 2020.ADDITIONAL FUNDING FOR THIS PROGRAM IS PROVIDED THROUGH FEDERAL GRANTS, AS SHOWN ON FORM 990, PART VIII, LINE 1E. 3247188 5193141 OPEN DOOR FAMILY MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER WHICH SERVED APPROXIMATELY 10,455 MENTAL HEALTH PATIENTS THAT GENDERATED 38,022 VISITS IN 2020.ADDITIONAL FUNDING FOR THIS PROGRAM IS PROVIDED THROUGH FEDERAL GRANTS, AS SHOWN ON FORM 990, PART VIII, LINE 1E. 49007111 1 1 0 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 0 0 0 0 0 1 1 1 0 0 1 62 0 1 718 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 13 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 ANDRES VALDESPINO VICE-CHAIRMAN 1.00 X X 0 0 0 ANTONIO MEJIAS BOARD MEMBER 1.00 X 0 0 0 BARBARA ILARDI BOARD MEMBER 1.00 X 0 0 0 BLAKELEY LOWRY BOARD MEMBER 1.00 X 0 0 0 CHARLES CHEHEBAR BOARD MEMBER 1.00 X 0 0 0 DANIEL ROSS CHAIRMAN 1.00 X X 0 0 0 DAVID WHITLINGER BOARD MEMBER (THRU 05/20) 1.00 X 0 0 0 DAYSI BRIONES SECRETARY 1.00 X X 0 0 0 DORIAN LINDSAY BOARD MEMBER 1.00 X 0 0 0 HOWARD S SCHRADER BOARD MEMBER 1.00 X 0 0 0 MARGOTH PILLA TREASURER 1.00 X X 0 0 0 MARIE PENNACCHIO BOARD MEMBER (FROM 05/20) 1.00 X 0 0 0 MICHELLE HORVATH BOARD MEMBER 1.00 X 0 0 0 SHIRLEY BUONTEMPO BOARD MEMBER (THRU 02/20) 1.00 X 0 0 0 TYLER BEEBE BOARD MEMBER 1.00 X 0 0 0 WALTER EDGE BOARD MEMBER (THRU 11/20) 1.00 X 0 0 0 LINDSAY C FARRELL PRESIDENT & CEO 35.50 2.00 X 376962 19840 21880 MARIA MAZZOTTA CHIEF FINANCE OFFICER 35.50 2.00 X 239349 12597 9972 DAREN WU CHIEF MEDICAL OFFICER 37.50 X 366491 0 9975 NAIDA HENRIQUEZ CHIEF DENTAL OFFICER 37.50 X 205594 0 14456 BRUCE M SHAFFER PODIATRIST 37.50 X 251041 0 30134 HEATHER LYNN LURIE OB/GYN PHYSICIAN 37.50 X 263425 0 18261 JAY ABRAM ZASLOW FAMILY PRACTICE PHYSICIAN 37.50 X 279428 0 25700 KAREN MURRAY OB/GYN PHYSICIAN 37.50 X 336501 0 31869 THOMAS YUEN FAMILY PRACTICE PHYSICIAN 37.50 X 258818 0 40871 2577609 32437 203118 81 0 1 0 HITCH 2 CHURCH STREET OSSINING NY 10562 MANAGEMENT SERVICES 764602 MEDCOR GROUP 1801 W OLYMPIC BLVD PASADENA CA 91199 MEDICAL BILLING 720000 ECLINICAL WORKS 2 TECHNOLOGY DRIVE WESTBORO MA 01581 ECW SUPPORT 511470 COMPREHENSIVE EYE SERVICES PO BOX 187 ARMONK NY 10504 EYE CLINIC 450765 GARFUNKEL WILD PC 111 GREAT NECK ROAD GREAT NECK NY 11021 LEGAL 369508 8 800000 19577821 3105397 23483218 MEDICAID MANAGED CARE PLAN 621400 12152867 12152867 NYS MANAGED CARE WRAPAROUND 621400 9660481 9660481 MEDICAID 621400 6031604 6031604 NYS SAFETY NET FUNDS 621400 4770327 4770327 OTHER THIRD-PARTY PAYORS 621400 3064266 3064266 4847346 4847346 40526891 1858825 1858825 267032 0 267032 267032 220252 46780 5268802 4350025 918777 918777 918777 MANAGEMENT SERVICES 900099 2448240 2448240 MISCELLANEOUS REVENUE 900099 174902 174902 2623142 69677885 43150033 220252 2824382 1243088 1072757 170331 33122815 28490733 4632082 816279 754503 61776 3245915 3000264 245651 2827222 2613258 213964 61975 61975 100434 100434 255246 255246 5282590 3912422 1370168 1974512 1755695 218817 43872 43872 1278581 987760 290821 29732 13919 15813 54647 25584 29063 185673 147270 38403 2479745 1966857 512888 255481 202640 52841 PHARMACEUTICALS 1691028 1691028 REPAIRS & MAINTENANCE 1334392 1058398 275994 DATA PROCESSING 388872 217215 171657 EQUIPMENT RENTAL 362377 287426 74951 962812 809382 153430 57997288 49007111 8990177 0 5696868 7509597 270332 8472495 1367570 1841902 5069218 6321745 607070 372659 58035854 27152731 32248021 30883123 79263731 88158870 686214 1077925 125209024 144638316 4990313 5593992 184020 828366 5036298 4090109 1131441 989128 11342072 11501595 X 113828202 133066662 38750 70059 113866952 133136721 125209024 144638316 11680597 7589172 0 X X 0 1 X 1 1 1 X 11820630 15451895 16139421 12879694 23483218 79774858 11820630 15451895 16139421 12879694 23483218 79774858 79774858 1062692 1228572 1662687 1889424 2079077 7922452 555988 2993385 3276621 2550031 2623142 11999167 99696477 201649972 0.80020 0.75370 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2016 AMOUNT: $ 17,756. 2017 AMOUNT: $ 12,687. 2018 AMOUNT: $ 156,137. 2019 AMOUNT: $ 126,698. 2020 AMOUNT: $ 174,902. MANAGEMENT SERVICES - 2016 AMOUNT: $ 342,632. 2017 AMOUNT: $ 2,780,694. 2018 AMOUNT: $ 2,564,584. 2019 AMOUNT: $ 2,338,333. 2020 AMOUNT: $ 2,448,240. MEDICAID MEANINGFUL USE INCENTIVE - 2016 AMOUNT: $ 195,600. 2017 AMOUNT: $ 200,004. 2018 AMOUNT: $ 555,900. 2019 AMOUNT: $ 85,000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4315016 4315016 19022075 3280680 15741395 18498548 12056668 6441880 12277496 9383660 2893836 3922719 2431723 1490996 30883123 DUE TO RELATED PARTY 447679 CAPITAL LEASE OBLIGATION 541449 989128 X 78731525 7589172 127500 4040454 11757126 66974399 255246 2448240 2703486 69677885 58021614 127500 152072 279572 57742042 255246 255246 57997288 PART X, LINE 2: THE ORGANIZATION HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2020 AND 2019. THE ORGANIZATION'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO CALENDAR YEAR 2017 ARE CLOSED, AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE ORGANIZATION HAS UNRELATED BUSINESS INCOME TAXES, IT WOULD RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE CONSOLIDATED STATEMENTS OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: INTERCOMPANY ELIMINATIONS -1,541,398. REVENUE OF RELATED ENTITIES 5,581,852. PART XI, LINE 4B - OTHER ADJUSTMENTS: MANAGEMENT SERVICES 2,448,240. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES OF RELATED ENTITIES 4,141,710. INTERCOMPANY ELIMINATIONS -1,541,398. MANAGEMENT SERVICES -2,448,240. X X X 0 0 0 0 0 1 0 1 0 LINDSAY C FARRELL PRESIDENT & CEO 348811 18359 24739 1302 3412 179 9476 499 11310 595 397748 20934 0 0 DAREN WU CHIEF MEDICAL OFFICER 334189 0 30905 0 1397 0 9975 0 0 0 376466 0 0 0 KAREN MURRAY OB/GYN PHYSICIAN 299381 0 35473 0 1647 0 9975 0 21894 0 368370 0 0 0 JAY ABRAM ZASLOW FAMILY PRACTICE PHYSICIAN 252411 0 25051 0 1966 0 9854 0 15846 0 305128 0 0 0 THOMAS YUEN FAMILY PRACTICE PHYSICIAN 231055 0 26600 0 1163 0 9562 0 31309 0 299689 0 0 0 HEATHER LYNN LURIE OB/GYN PHYSICIAN 239763 0 21160 0 2502 0 3485 0 14776 0 281686 0 0 0 BRUCE M SHAFFER PODIATRIST 241497 0 5600 0 3944 0 9049 0 21085 0 281175 0 0 0 MARIA MAZZOTTA CHIEF FINANCE OFFICER 231437 12180 6650 350 1262 67 8393 442 1080 57 248822 13096 0 0 NAIDA HENRIQUEZ CHIEF DENTAL OFFICER 186843 0 15725 0 3026 0 4846 0 9610 0 220050 0 0 0 PART I, LINE 6 THE FOLLOWING INDIVIDUALS, LISTED ON PART VII, RECEIVED INCENTIVE BONUSES, WHICH ARE BASED ON INDIVIDUAL AND SITE PERFORMANCE, DURING THE YEAR ENDED 12/31/19: DAREN WU - $37,000 THOMAS YUEN - $40,300 KAREN MURRAY - $35,300 JAY ABRAM ZASLOW - $40,813 REBECCA COLLINS - $38,000 PART I, LINE 7 INCLUDED IN PART II COLUMN B(II) ARE AMOUNTS REPRESENTING BONUS PAYMENTS. THESE AMOUNTS WERE APPROVED BY THE BOARD AND INCLUDED IN THE INDIVIDUALS' 2019 W-2S. FORM 990, PART VI, SECTION B, LINE 11B 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/CEO AND CFO REVIEW THE FORM 990 AND SCHEDULES FOR ACCURACY. IN 2019, THE FORM 990, FOR THE YEAR ENDED DECEMBER 31, 2019, WAS PRESENTED TO THE FINANCE COMMITTEE AND BOARD MEMBERS FOR REVIEW PRIOR TO ITS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, ALL THE BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. ALL DISCLOSURE STATEMENTS ARE UPDATED AND REVIEWED ANNUALLY FOR EXISTING OR POTENTIAL CONFLICTS BY THE PRESIDENT/CEO. IF A CONFLICT IS FOUND, THE AFFECTED INDIVIDUAL IS REQUIRED TO RECUSE HIMSELF/HERSELF FROM ANY DECISION MAKING AND VOTING RELATING TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD CONDUCTS PARITY STUDIES TO EVALUATE EXECUTIVE COMPENSATION. THE ENTIRE BOARD GOES INTO EXECUTIVE SESSION TO EVALUATE THE CEO AND DETERMINE COMPENSATION. THE CEO CONDUCTS PARITY STUDIES TO EVALUATE OFFICERS AND KEY EMPLOYEES' SALARIES FOR THE EXECUTIVE COMMITTEE. THESE SALARIES, AND THE SALARIES OF THE ENTIRE ORGANIZATION, ARE PRESENTED TO THE BOARD FOR APPROVAL DURING THE BUDGET APPROVAL PROCESS TOWARD YEAR-END. THERE IS CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION DELIBERATION AND DECISION IN THE BOARD MINUTES. 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 FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D); AND INSPECTION AT AN OFFICE OF THE ORGANIZATION. THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST, AT THE ORGANIZATION'S LOCATION. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AS WELL AS THE SELECTION OF THE INDEPENDENT ACCOUNTANT. OPEN DOOR FOUNDATION INC 165 MAIN STREET OSSINING NY 10562 133598184 FUNDRAISING/DEVELOPMENT NY 501(C)(3) LINE 7 OPEN DOOR FAMILY MEDICAL CENTER INC 1 OPEN DOOR LEASING CORP 165 MAIN STREET OSSINING NY 10562 201726717 LEASING SPACE NY OPEN DOOR FAMILY MEDICAL CENTER INC C 741805 28358 1.00000 1 EUGENE P HESLIN MD PC DBA BRIDGE STREET FAMILY MEDICINE 12 WEST BRIDGE ST SAUGERTIES NY 12466 141794395 MEDICAL PRACTICE NY OPEN DOOR FAMILY MEDICAL CENTER INC C 2094903 839246 1.00000 1 0 0 1 1 0 0 0 0 0 1 1 0 1 1 0 1 0 0 0 OPEN DOOR LEASING CORP K 741805 COST