2022-11-04T13:46:36-05:00 2021-12-31 042571780 AAFCPAS INC 50 WASHINGTON STREET WESTBOROUGH MA 01581 990 2021-01-01 050368134 THE PROVIDENCE COMMUNITY HEALTH CENTERS INC PROV 4014440400 375 ALLENS AVENUE PROVIDENCE RI 029055010 MERRILL THOMAS CHIEF EXECUTIVE OFFICER 4014440400 2022-10-31 1 MERRILL THOMAS XXX-XX-XXXX CHARLES J WEBB CPA P01584539 5083669100 2022-10-31 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z MERRILL THOMAS 375 ALLENS AVENUE PROVIDENCE RI 02905 91155013 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. 14 13 744 12 0 0 20367282 15806369 59583126 69917001 403089 496111 2118079 2439626 82471576 88659107 0 1885218 0 0 52775051 57503071 0 0 0 25481937 25645198 78256988 85033487 4214588 3625620 81139584 92213963 28850918 35023569 52288666 57190394 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 54469130 1885218 57779667 PATIENT SERVICEPROVISION OF PRIMARY HEALTH CARE TO RESIDENTS IN PROVIDENCE ALSO PROVIDING SPECIALIZED CARE AT 10 SITES IN PROVIDENCE. IN FY21, WE SERVED OVER 59,400 PATIENTS WITH OVER 276,300 PATIENT VISITS. 5401974 4407528 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 FY21, WE SERVED 9,200 PATIENTS WITH 18,800 PATIENT VISITS. 5826741 10220328 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 FY21 THERE WERE 43,395 PATIENTS UTILIZING CONTRACT PHARMACY AND 325,458 PRESCRIPTIONS SENT TO CONTRACT PHARMACY. 65697845 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 61 0 1 744 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 13 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 ELENA NICOLELLA BOARD CHAIR (UNTIL 11/2021) 1.00 X X 0 0 0 CARL BROWN BOARD VICE CHAIR/CHAIR (AS OF 11/2021) 1.00 X X 0 0 0 AMBER BICHUN BOARD TREASURER/VICE CHAIR 1.00 0.10 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 RICHARD HEMPHILL BOARD MEMBER 1.00 X 0 0 0 JOSEPH NAGLE BOARD MEMBER 1.00 X 0 0 0 CHRISTY ANGEVINE BOARD MEMBER 1.00 X 0 0 0 MERRILL R THOMAS CEO 40.00 1.00 X 518168 0 24794 KEVIN CABRAL VP & CFO 40.00 1.00 X 223786 0 16983 ANDREW D SAAL VP AND CMO 40.00 X 397828 0 26957 KIMBERLY A O'CONNELL VP & CTO 40.00 X 330011 0 25829 CHERYL PERRY VP & CHRO 40.00 X 251045 0 16104 JAY DECOSTA VP & CIO 40.00 X 183354 0 29980 RAYMOND G PARRIS EXECUTIVE DIRECTOR 40.00 X 247280 0 33138 SUSANA CONKLIN VP & CHIEF OF STAFF 40.00 X 225850 0 24954 DILEK CERMIK MD OB/GYN 40.00 X 413097 0 27875 JONATHAN GATES CMO OF ACCOUNTABLE ENTITY 40.00 X 291641 0 34955 ALTUG KOYMEN MD OB/GYN 40.00 X 314156 0 26264 EMILY WHITE MD OB/GYN 40.00 X 304765 0 24666 STANLEY BLOCK EMERITUS CMO 35.00 X 280912 0 28485 3981893 0 340984 117 0 1 0 NEW ENGLAND CONSTRUCTION 293 BOURNE AVENUE RUMFORD RI 02916 CONSTRUCTION CONTRACTOR 3705172 CASE CONSTRUCTION CO 225 WAMPANOAG TRL EAST PROVIDENCE RI 02915 CONSTRUCTION CONTRACTOR 2086236 THE GREYSMITH COMPANIES 125 WHIPPLE STREET PROVIDENCE RI 02908 EMPLOYMENT AGENCY 659012 JVT ADVISORS 35 NEW ENGLAND BUSINESS CENTER ANDOVER MA 01810 RECRUITMENT AGENCY 475115 RIBI SECURITY 14 INTERNATIONAL WAY WARWICK RI 02886 SECURITY AGENCY 466355 10 82655 8374090 7349624 15806369 PATIENT SERVICE REVENUE 621110 69917001 69917001 69917001 340408 340408 2600713 2445010 155703 155703 155703 0 82655 50896 -50896 -50896 RENTAL INCOME 900002 2308736 2308736 MISCELLANEOUS 621110 181786 181786 2490522 88659107 72407523 0 445215 1885218 1885218 2624683 2624683 42871849 36153006 6718843 1739126 1396553 342573 7214296 5624715 1589581 3053117 2342262 710855 36000 36000 258365 258365 138086 138086 3170420 1589349 1581071 13905 13905 681004 427405 253599 5450446 3620631 1829815 203451 21037 182414 847071 315249 531822 2003799 1274042 729757 679982 425437 254545 MEDICAL SUPPLIES AND SE 4382203 4382203 DATA PROCESSING 2678545 2203920 474625 LICENSES & FEES 2545613 2545613 BAD DEBT 869066 869066 1687242 622139 1065103 85033487 65697845 19335642 0 11167806 6931757 4060271 351066 11165788 16938647 968685 1937370 519121 9999583 1037004 667122 58281887 18525332 39621729 39756555 6702356 11197512 5896824 4434351 81139584 92213963 6383378 6586575 8982668 8576685 9877468 15840007 3607404 4020302 28850918 35023569 X 51761639 56263367 527027 927027 52288666 57190394 81139584 92213963 X 3625620 420619 855489 X X 0 1 X 1 1 1 X 10335851 9862370 12742364 20367282 15806369 69114236 10335851 9862370 12742364 20367282 15806369 69114236 69114236 596517 620892 621856 360721 340408 2540394 128365 148355 522228 2118079 2490522 5407549 77062179 286759354 0.89690 0.91290 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3159583 3159583 45021839 10771083 34250756 9855597 7647073 2208524 244868 107176 137692 39756555 DEFERRED LEASE PAYABLE 1497160 ACCUMULATED UNREALIZED LOSS ON INTEREST RATE SWAP CONTRACT 712767 CONDITIONAL GRANT ADVANCE 1783867 DUE TO AFFILIATES 26508 4020302 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. GOLF TOURNAMENT 82655 82655 19414 20280 11202 82655 82655 19414 20280 11202 50896 -50896 1 PCHC ATWOOD INC 375 ALLENS AVENUE PROVIDENCE RI 02905 863765025 501(C)3 1885218 0 TO PROVIDE FUNDING IN SUPPORT OF PROGRAM INITIATIVES 1 PART I, LINE 2: PCHC GRANTS FUNDS ARE MONITORED MONTHLY. GRANTS ARE ALLOCATED BASED UPON ACTUAL EXPENDITURES INCURRED EACH MONTH. MONTHLY EXPENDITURE REPORTS ARE PRODUCED OUT OF THE ADP PAYROLL SYSTEM AS WELL AS THE PRACTICE ANALYTICS SYSTEM. ONCE THE EXPENDITURE REPORTS ARE PRODUCED, DEPENDING ON THE GRANT SOURCE, EITHER A MANUAL INVOICE IS CREATED AND SUBMITTED TO THE DESIGNATED GRANTOR OR A DRAWDOWN IS REQUESTED VIA THE PAYMENT MANAGEMENT SERVICES SYSTEM. EXCEL GRANT SPREADSHEETS ARE UPDATED AND MAINTAINED MONTHLY BY THE FINANCE DEPARTMENT. X X 0 0 0 0 0 0 0 0 0 MERRILL R THOMAS CEO 518168 0 0 0 0 0 10183 0 14611 0 542962 0 0 0 DILEK CERMIK MD OB/GYN 413097 0 0 0 0 0 7420 0 20455 0 440972 0 0 0 ANDREW D SAAL VP AND CMO 397828 0 0 0 0 0 6502 0 20455 0 424785 0 0 0 KIMBERLY A O'CONNELL VP & CTO 330011 0 0 0 0 0 12386 0 13443 0 355840 0 0 0 ALTUG KOYMEN MD OB/GYN 314156 0 0 0 0 0 11653 0 14611 0 340420 0 0 0 EMILY WHITE MD OB/GYN 304765 0 0 0 0 0 10055 0 14611 0 329431 0 0 0 JONATHAN GATES CMO OF ACCOUNTABLE ENTITY 291641 0 0 0 0 0 14500 0 20455 0 326596 0 0 0 STANLEY BLOCK EMERITUS CMO 280912 0 0 0 0 0 21181 0 7304 0 309397 0 0 0 RAYMOND G PARRIS EXECUTIVE DIRECTOR 247280 0 0 0 0 0 12683 0 20455 0 280418 0 0 0 CHERYL PERRY VP & CHRO 251045 0 0 0 0 0 8800 0 7304 0 267149 0 0 0 SUSANA CONKLIN VP & CHIEF OF STAFF 225850 0 0 0 0 0 11511 0 13443 0 250804 0 0 0 KEVIN CABRAL VP & CFO 223786 0 0 0 0 0 9679 0 7304 0 240769 0 0 0 JAY DECOSTA VP & CIO 183354 0 0 0 0 0 9525 0 20455 0 213334 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 3538315 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 1937370 0 1 1 1937370 MERRILL THOMAS CEO 1761300 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 MERRILL THOMAS CEO 28303000 BOARD MEMBER OF FUNDING SOURCE. THE CEO OF THE HEALTH CENTER SERVES ON THE BOD OF NHPRI, WHICH PROVIDES THIRD PARTY REVENUE TO THE HEALTH CENTER 0 MERRILL THOMAS CEO 497727 BOARD MEMBER OF FUNDING SOURCE, HEALTH CHOICE CARE. 0 MERRILL THOMAS CEO 46000 BOARD MEMBER OF FUNDING SOURCE. THE HEALTH CENTER RECEIVES GRANT FUNDING FROM THIS ORGANIZATION 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 GAIN ON CARRYING VALUE OF INTEREST RATE SWAP 855,489. 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 -200919 -162236 THE PROVIDENCE COMMUNITY HEALTH CENTERS INC PCHC ATWOOD INC 375 ALLENS AVE PROVIDENCE RI 02905 863765025 SUPPORT PROVIDENCE COMMUNITY HEALTH CENTER RI 501(C)(3) LINE 12A, I THE PROVIDENCE COMMUNITY HEALTH CENTERS INC 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PCHC ATWOOD INC B 1885218 FMV