2023-01-24T13:30:49-06:00 2022-09-30 721396621 CARR RIGGS & INGRAM LLC 215 BAYTREE DRIVE MELBOURNE FL 32940 990 2021-10-01 900068515 BREVARD HEALTH ALLIANCE INC BREV 3217494781 4315 WOODLAND PARK DRIVE WEST MELBOURNE FL 32904 AUSTIN HELTON CHIEF EXECUTIVE CEO 3217494781 2023-01-19 1 AUSTIN HELTON CHIEF EXECUTI 999009999 THOMAS LIND CPA P01826715 3212550088 2023-01-18 3 AAL1 IAL1 2021 2023-03-07 01:45:13Z RICHARD AUSTIN HELTON 4315 WOODLAND PARK DRIVE WEST MELBOURNE FL 32904 57510822 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 BY PROVIDING A MEDICAL HOME WHERE ALL PATIENTS RECEIVE HIGH-QUALITY CARE IN A TIMELY MANNER. WE COMMIT TO ENSURING EVERY PATIENT WE SERVE IS HEARD, ENCOURAGED, AND RESPECTED. 10 10 547 135 0 0 15914203 13803022 37975628 43529925 -1339 50524 121740 127014 54010232 57510485 0 826000 0 0 30035917 34666971 0 0 0 11194903 13981675 41230820 49474646 12779412 8035839 31974124 40519404 5715998 6687683 26258126 33831721 X THE MISSION OF THE BREVARD HEALTH ALLIANCE, INC. IS TO IMPROVE THE HEALTH STATUS OF BREVARD COUNTY BY PROVIDING A MEDICAL HOME WHERE ALL PATIENTS RECEIVE HIGH-QUALITY CARE IN A TIMELY MANNER. WE COMMIT TO ENSURING EVERY PATIENT WE SERVE IS HEARD, ENCOURAGED, AND RESPECTED. 0 0 42790187 826000 43656939 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 1,740,000 MEDICAL, DENTAL, AND BEHAVIORAL HEALTH VISITS, ENABLED FREE MEDICATIONS FOR OUR PATIENTS VALUED AT MORE THAN $60.5 MILLION AT AVERAGE WHOLESALE PRICE, AND ENABLED FREE DIAGNOSTIC SERVICES VALUED AT MORE THAN $54.5 MILLION. DURING FYE 9/30/22, BHA PROVIDED OVER 240,000 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 152,000 PRESCRIPTIONS AT 340B PRICING TO ENABLE ACCESS TO MEDICATIONS FOR OUR PATIENTS. MORE THAN 23% OF PATIENTS SERVED WERE UNINSURED, AND 65% OF PATIENTS SERVED WERE BELOW 100% OF THE FEDERAL POVERTY GUIDELINE. 42790187 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 1 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 2 0 1 547 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 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 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 LEIGH PETTIGREW SECRETARY 1.00 X 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 DR SYNTHIA DOAKS DIRECTOR 1.00 X 0 0 0 RICHARD A HELTON CHIEF EXECUTIVE OFFICER 40.00 X 237062 0 16610 RICHARD ALOYSIUS NESCIO CHIEF FINANCIAL OFFICER 40.00 X 225390 0 27595 MAEGEN ANDERSON CHIEF OPERATING OFFICER 40.00 X 236037 0 20751 THEODORE SCHUCK CHIEF MEDICAL OFFICER 40.00 X 290204 0 30188 JOHN EMIL MALEK CHIEF COMPLIANCE OFFICER A 40.00 X 254096 0 22929 SANTIAGO DE LOS ANGELES PHYSICIAN- PSYCHIATRY 40.00 X 249296 0 18216 WENDY L LOCKHART CHIEF OF PEDIATRICS 40.00 X 209475 0 26958 MICHAEL SEAN GARVEY CHIEF INFORMATION OFFICER 40.00 X 222225 0 8286 ROBERT JOHN WALTERS CHIEF HUMAN RESOURCES OFFICER 40.00 X 218610 0 21446 MARY ROSE BARRIOS BANAL PHYSICIAN - PEDIATRICS 40.00 X 292363 0 12699 2434758 0 205678 74 0 1 0 MORSE COMMUNICATIONS 395 EAST DRIVE MELBOURNE FL 32904 IT SERVICES, HOSTING, CIRCUITS 1260586 ECLINICALWORKS 2 TECHNOLOGY DRIVE WESTBOROUGH MA 01581 PLATFORM FOR PATIENT SCHEDULING, BILLING 1063889 ICHIBAN CLEANING 793 NORTH DRIVE SUITE F MELBOURNE FL 32934 CLEANING SERVICES 332336 STRATUS VIDEO PO BOX 674954 DETROIT MI 48267 TRANSLATION SERVICES 122872 TRIZETTO PO BOX 734743 CHICAGO IL 60673 ECW INTEGRATED PACKAGE FOR PATIENT STATE 118377 5 X 9933260 3869762 13803022 PATIENT SERVICE REVENUE 621400 35893515 35893515 CAPITATION REVENUE 621400 7636410 7636410 43529925 7848 7848 43013 0 337 43013 -337 42676 42676 MISCELLANEOUS MEDICAL REVENUE 621400 127014 127014 127014 57510485 43656939 0 50524 826000 826000 2806527 2357482 449045 25787220 21661257 4125963 680217 571382 108835 3289114 2762855 526259 2103893 1767269 336624 27618 27618 237269 237269 1705217 1619624 85593 375357 246085 129272 1490315 1315854 174461 40403 20202 20201 113435 22687 90748 8304 8304 1434441 1290998 143443 225027 168767 56260 BILLING EXPENSES 3130319 3130319 SUPPLIES- PHARMACY 3053256 3053256 SUPPLIES- MEDICAL 1333752 1333752 TRAINING 300310 180204 120106 506652 453890 52762 49474646 42790187 6684459 0 14809713 6550065 1054472 15005923 937632 756618 5120290 6162060 623834 858099 15903228 7319846 7188068 8583382 2144734 2502263 95381 100994 31974124 40519404 5285630 6476671 249419 204713 180949 6299 5715998 6687683 X 26258126 33831721 26258126 33831721 31974124 40519404 8035839 -462244 0 X 0 1 X 1 1 1 X 8899266 8744233 8445858 15914203 13803022 55806582 8899266 8744233 8445858 15914203 13803022 55806582 55806582 8578 5646 478 3049 7848 25599 55832181 148781338 0.99950 0.99970 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 644720 644720 670183 409780 260403 8336984 3810148 4526836 5222618 3099918 2122700 1028723 1028723 8583382 REFUNDABLE ADVANCES 6299 6299 X 57700445 -462244 652204 189960 57510485 0 57510485 50126850 652204 652204 49474646 0 49474646 PART X, LINE 2: UNDER SECTION 501(C)(3) 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, 2022, THE ALLIANCE HAS NO UNCERTAIN TAX PROVISIONS THAT QUALIFY FOR RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. 1 THE FLORIDA ASSOCIATION OF COMMUNITY HEALTH CENTERS INC 2340 HANSEN LANE TALLAHSSEE FL 32301 592559163 501(C)(3) 826000 0 TO CONTRIBUTE TO THE PRIMARY CARE CAPACITY FUND PROGRAM ESTABLISHED BY FACHC. 1 PART 1, LINE 2 IN AN EFFORT TO ENSURE CONTINUING SUPPORT FOR THE FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) THAT PROVIDE UNCOMPENSATED CARE TO THE MEDICAID, UNINSURED AND UNDERINSURED POPULATIONS OF FLORIDA, THE FLORIDA ASSOCIATION OF COMMUNITY HEALTH CENTERS (FACHC), AT THE DIRECTION OF ITS BOARD OF DIRECTORS, ESTABLISHED THE PRIMARY CARE CAPACITY GRANT FUND PROGRAM (FUND). THE FUND WAS ESTABLISHED THROUGH THE VOLUNTARY CONTRIBUTIONS OF FLORIDA FQHCS. FOR PURPOSES AS SET FORTH ABOVE BREVARD HEALTH ALLIANCE DESIRES TO PARTICIPATE IN THIS PROGRAM AND CONTRIBUTE $826,000 TO THE FACHC PRIMARY CARE CAPACITY GRANT FUND. IT IS UNDERSTOOD THAT THESE FUNDS ARE TO BE DISBURSED BY FACHC FOR THE PURPOSES SET FORTH IN THE FUND. FUND RECIPIENTS WILL BE OBLIGATED TO DEMONSTRATE THAT ALL FUNDS PROVIDED WERE USED FOR AN APPROPRIATE PURPOSE AS SET FORTH IN THE FUND. X X X X 0 1 0 0 0 0 0 0 0 THEODORE SCHUCK CHIEF MEDICAL OFFICER 239754 0 50450 0 0 0 11607 0 18581 0 320392 0 0 0 MARY ROSE BARRIOS BANAL PHYSICIAN - PEDIATRICS 157540 0 12500 0 122323 0 11693 0 1006 0 305062 0 0 0 JOHN EMIL MALEK CHIEF COMPLIANCE OFFICER A 219096 0 35000 0 0 0 4905 0 18024 0 277025 0 0 0 SANTIAGO DE LOS ANGELES PHYSICIAN- PSYCHIATRY 248796 0 500 0 0 0 9970 0 8246 0 267512 0 0 0 MAEGEN ANDERSON CHIEF OPERATING OFFICER 204037 0 32000 0 0 0 8230 0 12521 0 256788 0 0 0 RICHARD A HELTON CHIEF EXECUTIVE OFFICER 237062 0 0 0 0 0 7969 0 8641 0 253672 0 0 0 RICHARD ALOYSIUS NESCIO CHIEF FINANCIAL OFFICER 195820 0 29570 0 0 0 9014 0 18581 0 252985 0 0 0 ROBERT JOHN WALTERS CHIEF HUMAN RESOURCES OFFICER 189010 0 29600 0 0 0 7679 0 13767 0 240056 0 0 0 WENDY L LOCKHART CHIEF OF PEDIATRICS 196975 0 12500 0 0 0 8377 0 18581 0 236433 0 0 0 MICHAEL SEAN GARVEY CHIEF INFORMATION OFFICER 192655 0 29570 0 0 0 8286 0 0 0 230511 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. 173643 CIA DEVELOPERS, INC. LEASES THE BUILDING TO BHA AS WELL AS SPACE FOR THE STORAGE OF BHA'S MOBILE UNIT 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 VIII LINE 1G DONATED SERVICES AND RENT ARE NOT REPORTED AS NON-CASH CONTRIBUTIONS. 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 $322,204 FOR THE PORT ST. JOHN'S CENTER.