2022-06-20T07:59:44-05:00 2021-09-30 721396621 CARR RIGGS & INGRAM LLC 215 BAYTREE DRIVE MELBOURNE FL 32940 990 2020-10-01 900068515 BREVARD HEALTH ALLIANCE INC BREV 3217494781 4315 WOODLAND PARK DRIVE WEST MELBOURNE FL 32904 AUSTIN HELTON CHIEF EXECUTIVE CEO 3217494781 2022-06-20 1 AUSTIN HELTON CHIEF EXECUTI 999009999 THOMAS LIND CPA P01826715 3212550088 2022-06-20 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z RICHARD AUSTIN HELTON 4315 WOODLAND PARK DRIVE WEST MELBOURNE FL 32904 54014620 0 X WWW.BREVARDHEALTH.ORG X 2003 FL THE MISSION OF THE BREVARD HEALTH ALLIANCE, INC. IS TO IMPROVE THE HEALTH STATUS OF BREVARD COUNTY'S MEDICALLY UNDERSERVED POPULATIONS BY PROVIDING AN EXTRAORDINARY QUALITY OF SERVICE AND CARE IN THE AREAS OF PRIMARY HEALTH CARE, DENTAL HEALTH CARE, MENTAL HEALTH CARE, PREVENTIVE SERVICES, AND EDUCATIONAL SERVICES. 11 11 460 150 0 0 8445858 15914203 25304737 37975628 -11974 -1339 0 121740 33738621 54010232 0 0 0 0 24916995 30035917 0 0 0 9581968 11194903 34498963 41230820 -760342 12779412 22397296 31974124 8867701 5715998 13529595 26258126 X THE MISSION OF THE BREVARD HEALTH ALLIANCE, INC. IS TO IMPROVE THE HEALTH STATUS OF BREVARD COUNTY'S MEDICALLY UNDERSERVED POPULATIONS BY PROVIDING AN EXTRAORDINARY QUALITY OF SERVICE AND CARE IN THE AREAS OF PRIMARY HEALTH CARE, DENTAL HEALTH CARE, MENTAL HEALTH CARE, PREVENTIVE SERVICES, AND EDUCATIONAL SERVICES. 0 0 35585590 38097368 BREVARD HEALTH ALLIANCE PROVIDES PRIMARY MEDICAL, DENTAL, BEHAVIORAL HEALTH AND WOMEN'S HEALTH SERVICES, HEPATITIS C AND HIV TREATMENTS, EXTENDED HOURS PEDIATRIC WALK-IN CARE, AND PHARMACY SERVICES TO THE CITIZENS OF BREVARD COUNTY. TO COMPLEMENT PRIMARY CARE SERVICES, BHA ALSO PROVIDES MEDICATION ASSISTANCE AND DIAGNOSTIC ASSISTANCE. SINCE INCEPTION IN MARCH 2005, BHA HAS PROVIDED MORE THAN 1,500,000 MEDICAL, DENTAL, AND BEHAVIORAL HEALTH VISITS, ENABLED FREE MEDICATIONS FOR OUR PATIENTS VALUED AT MORE THAN $60 MILLION AT AVERAGE WHOLESALE PRICE, AND ENABLED FREE DIAGNOSTIC SERVICES VALUED AT MORE THAN $54 MILLION. DURING FYE 9/30/21, BHA PROVIDED OVER 250,000 MEDICAL, DENTAL, BEHAVIORAL HEALTH, WOMEN'S HEALTH, SUBSTANCE USE DISORDER, AND ENABLING SERVICES VISITS. WITH THE INCREASE OF THE NEW PHARMACIES, BHA PHARMACISTS FILLED MORE THAN 143,000 PRESCRIPTIONS AT 340B PRICING TO ENABLE ACCESS TO MEDICATIONS FOR OUR PATIENTS. MORE THAN 25% OF PATIENTS SERVED WERE UNINSURED, AND 65% OF PATIENTS SERVED WERE BELOW 100% OF THE FEDERAL POVERTY GUIDELINE. 35585590 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 1 1 0 0 0 0 0 0 0 0 0 0 1 4 0 1 460 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X RICHARD NESCIO 3217494781 4315 WOODLAND PARK DR MELBOURNE FL 32904 X COLLEEN BROWNE DIRECTOR 1.00 X 0 0 0 KEITH DONALD DIRECTOR 1.00 X 0 0 0 BRETT ESROCK TREASURER 1.00 X X 0 0 0 JOHN BARRY FORBES DIRECTOR 1.00 X 0 0 0 KEVIN HILL DIRECTOR 1.00 X 0 0 0 LENA MARIE KNAPP DIRECTOR 1.00 X 0 0 0 DOREEN NIMBLETT SECRETARY 1.00 X X 0 0 0 LEIGH PETTIGREW DIRECTOR 1.00 X 0 0 0 ROBERT SANTIAGO VICE CHAIR 1.00 X X 0 0 0 ERIN SHEA CHAIRPERSON 1.00 X X 0 0 0 MIKE YOUNG DIRECTOR 1.00 X 0 0 0 CARICE CUNNINGHAM DIRECTOR 1.00 X 0 0 0 RICHARD A HELTON CHIEF EXECUTIVE OFFICER 40.00 X 226550 0 16488 RICHARD ALOYSIUS NESCIO CHIEF FINANCIAL OFFICER 40.00 X 218500 0 27150 MAEGEN ANDERSON CHIEF OPERATING OFFICER 40.00 X 220175 0 21203 THEODORE SCHUCK CHIEF MEDICAL OFFICER 40.00 X 253895 0 28566 JOHN EMIL MALEK CHIEF COMPLIANCE OFFICER AND GENERAL COUNSEL 40.00 X 227513 0 20912 SANTIAGO DE LOS ANGELES PHYSICIAN- PSYCHIATRY 40.00 X 252436 0 23711 DAVID HARDEN TODD PHYSICIAN - FAMILY PRACTICE 40.00 X 214742 0 25212 WENDY L LOCKHART CHIEF OF PEDIATRICS 40.00 X 198266 0 26341 MARIE CUSHMORE PHYSICIAN - FAMILY PRACTICE 40.00 X 181305 0 23849 MICHAEL SEAN GARVEY CHIEF INFORMATION OFFICER 40.00 X 178808 0 25562 LISA GURRI FORMER CHIEF EXECUTIVE OFFICER 40.00 X 493598 0 2648 2665788 0 241642 58 1 1 0 MORSE COMMUNICATIONS 395 EAST DRIVE MELBOURNE FL 32904 IT SERVICES, HOSTING, CIRCUITS 1061398 ECLINICALWORKS 2 TECHNOLOGY DRIVE WESTBOROUGH MA 01581 PLATFORM FOR PATIENT SCHEDULING, BILLING 832444 ICHIBAN CLEANING 793 NORTH DRIVE SUITE F MELBOURNE FL 32934 CLEANING SERVICES 279628 STRATUS VIDEO PO BOX 674954 DETROIT MI 48267 TRANSLATION SERVICES 119620 4 X 13307147 2607056 15914203 PATIENT SERVICE REVENUE 621400 32583899 32583899 CAPITATION REVENUE 621400 5391729 5391729 37975628 3049 3049 4388 -4388 -4388 -4388 MISCELLANEOUS MEDICAL REVENUE 621400 117223 117223 SURESCRIPTS REVENUE 621400 4517 4517 121740 54010232 38097368 0 -1339 2831903 2378798 453105 21869036 18369990 3499046 538155 452050 86105 3053535 2564969 488566 1743288 1464362 278926 183196 183196 1051173 998614 52559 322479 209832 112647 1493770 1344393 149377 57324 28662 28662 58644 11729 46915 9893 9893 1096939 987245 109694 207689 155874 51815 BILLING EXPENSES 2592005 2592005 SUPPLIES- PHARMACY 2265234 2265234 SUPPLIES- MEDICAL 1270825 1270825 REPAIRS AND MAINTENANCE 195850 176265 19585 389882 304850 85032 41230820 35585590 5645230 0 9945920 14809713 0 1054472 956471 937632 3979530 5120290 581828 623834 13082821 5894753 6836804 7188068 0 2144734 96743 95381 22397296 31974124 3875372 5285630 6299 0 292535 249419 4693495 180949 8867701 5715998 X 13529595 26258126 13529595 26258126 22397296 31974124 12779412 -50881 0 X 0 1 X 1 1 1 X 10385359 8899266 8744233 8445858 15914203 52388919 10385359 8899266 8744233 8445858 15914203 52388919 52388919 100 8578 5646 478 3049 17851 52406770 123132230 0.99970 0.80380 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 531203 531203 630317 383316 247001 7477763 3226681 4251082 4154874 2284756 1870118 288664 288664 7188068 REFUNDABLE ADVANCES 180949 180949 X 54543637 -50881 584286 533405 54010232 0 54010232 41815106 584286 584286 41230820 0 41230820 PART X, LINE 2: UNDER SECTION 501(C)(6) OF THE INTERNAL REVENUE CODE, THE ALLIANCE IS EXEMPT FROM TAXES ON INCOME OTHER THAN UNRELATED BUSINESS INCOME. THE ALLIANCE UTILIZES THE ACCOUNTING REQUIREMENTS ASSOCIATED WITH UNCERTAINTY IN INCOME TAXES USING THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ASC 740, INCOME TAXES. USING THAT GUIDANCE, TAX POSITIONS INITIALLY NEED TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS WHEN IT IS MORE-LIKELY-THAN-NOT THE POSITIONS WILL BE SUSTAINED UPON EXAMINATION BY THE TAX AUTHORITIES. IT ALSO PROVIDES GUIDANCE FOR DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. AS OF SEPTEMBER 30, 2021, THE ALLIANCE HAS NO UNCERTAIN TAX PROVISIONS THAT QUALIFY FOR RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. X X X X 0 1 0 0 0 0 0 0 0 LISA GURRI FORMER CHIEF EXECUTIVE OFFICER 70635 0 0 0 422963 0 2648 0 0 0 496246 0 0 0 THEODORE SCHUCK CHIEF MEDICAL OFFICER 253895 0 0 0 0 0 10156 0 18410 0 282461 0 0 0 SANTIAGO DE LOS ANGELES PHYSICIAN- PSYCHIATRY 252436 0 0 0 0 0 10098 0 13613 0 276147 0 0 0 JOHN EMIL MALEK CHIEF COMPLIANCE OFFICER AND GENERAL 227513 0 0 0 0 0 3048 0 17864 0 248425 0 0 0 RICHARD ALOYSIUS NESCIO CHIEF FINANCIAL OFFICER 218500 0 0 0 0 0 8740 0 18410 0 245650 0 0 0 RICHARD A HELTON CHIEF EXECUTIVE OFFICER 226550 0 0 0 0 0 7964 0 8524 0 243038 0 0 0 MAEGEN ANDERSON CHIEF OPERATING OFFICER 220175 0 0 0 0 0 8807 0 12396 0 241378 0 0 0 DAVID HARDEN TODD PHYSICIAN - FAMILY PRACTICE 214742 0 0 0 0 0 6802 0 18410 0 239954 0 0 0 WENDY L LOCKHART CHIEF OF PEDIATRICS 198266 0 0 0 0 0 7931 0 18410 0 224607 0 0 0 MARIE CUSHMORE PHYSICIAN - FAMILY PRACTICE 181305 0 0 0 0 0 5439 0 18410 0 205154 0 0 0 MICHAEL SEAN GARVEY CHIEF INFORMATION OFFICER 178808 0 0 0 0 0 7152 0 18410 0 204370 0 0 0 BRETT A ESROCK CEO, HOSPITAL DIVISION FOR HEALTH FIRST 330000 HEALTH FIRST PROVIDES IN-KIND LAB AND RADIOLOGY SERVICES FOR BHA 0 MAEGEN ANDERSON HER HUSBAND IS VP OF CIA DEVELOPERS, INC. 171012 CIA DEVELOPERS, INC. LEASES THE BUILDING TO BHA 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE FINANCE TEAM. ONCE CONFIRMED, IT IS THEN REVIEWED BY THE BOD FOR THEIR APPROVAL FORM 990, PART VI, SECTION B, LINE 12C THE CHIEF COMPLIANCE OFFICER MONITORS ANY POTENTIAL CONFLICT AND ENFORCES AS NECESSARY. FORM 990, PART VI, SECTION B, LINE 15 SALARY SURVEY DATA PRESENTED TO THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, AND THEN APPROVED BY THE FULL BOARD OF DIRECTORS. WE PERIODICALLY USE EXTERNAL COMPENSATION CONSULTATIONS TO FORMULATE RECOMMENDATIONS. THE OTHER OFFICERS AND KEY EMPLOYEES' COMPENSATION ARE BASED ON COMPETITIVE MARKET SALARY DATA. WE BENCHMARK OUR JOBS WITH SALARY SURVEY DATA FROM FLORIDA ASSOCIATION OF COMMUNITY HEALTH CENTERS (FACHC), NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC), AND COMPDATA SOUTHEASTERN SALARY SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS MADE AVAILABLE TO THE PUBLIC ONLY UPON REQUEST. PART VII SECTION A LISA GURRI HAD A 457B PAYOUT OF $422,962.68 THAT WAS TAXABLE AND HAD TO GO THROUGH PAYROLL. THESE WERE NOT ACTUALLY WAGES SHE EARNED SPECIFICALLY TO THIS CALENDAR YEAR. PART VIII LINE 1G DONATED SERVICES AND RENT ARE NOT REPORTED AS NON-CASH CONTRIBUTION. HOWEVER, THEY ARE INSTRUMENTAL TO OUR ORGANIZATION. HEALTH FIRST, INC. PROVIDED LABORATORY AND OTHER DIAGNOSTIC SERVICES TOTALING $330,000. SPACE COAST HEALTH FOUNDATION PROVIDED IN-KIND RENT ESTIMATED AT $254,286 FOR THE PORT ST. JOHN'S CENTER.