2024-11-04T08:51:47-06:00 2023-12-31 042571780 AAFCPAS INC 50 WASHINGTON STREET WESTBOROUGH MA 01581 990 2023-01-01 050368134 THE PROVIDENCE COMMUNITY HEALTH CENTERS INC PROV 4014440400 375 ALLENS AVENUE PROVIDENCE RI 029055010 MERRILL THOMAS CHIEF EXECUTIVE OFFICER 4014440400 2024-11-01 1 1 COURTNEY MCFARLAND CPA P01645518 5083669100 2024-11-01 2023 2024-10-15 13:58:12Z MERRILL THOMAS 375 ALLENS AVENUE PROVIDENCE RI 029055010 123949930 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. 15 15 832 16 0 0 22763178 36428048 79992937 83478853 612610 955121 2507681 1752352 105876406 122614374 0 161877 0 0 64248720 68810844 0 0 0 32456629 34108207 96705349 103080928 9171057 19533446 129084289 156874561 61958802 54799468 67125487 102075093 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 64937667 161877 59778553 PATIENT SERVICEPROVISION OF PRIMARY HEALTH CARE TO RESIDENTS IN PROVIDENCE ALSO PROVIDING SPECIALIZED CARE AT 13 SITES IN PROVIDENCE. IN FY23, WE SERVED OVER 62,500 PATIENTS WITH OVER 285,000 PATIENT VISITS. 5721975 4938243 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 FY23, WE SERVED 10,400 PATIENTS WITH 21,400 PATIENT VISITS. 11714374 18946189 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 FY23 THERE WERE 49,013 PATIENTS UTILIZING CONTRACT PHARMACY AND 371,085 PRESCRIPTIONS SENT TO CONTRACT PHARMACY. 82374016 1 1 0 0 0 0 0 0 0 0 1 0 0 1 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 46 0 1 832 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 RI X KEVIN CABRAL CHIEF FINANCIAL OFFICER 4014440400 375 ALLENS AVENUE PROVIDENCE RI 029055010 CARL BROWN BOARD CHAIR 1.00 X X 0 0 0 AMBER BICHUN TREAS. (UNTIL 12/23)/VICE CHAIR 1.00 0.10 X X 0 0 0 MEGHAN HOPKINS ESQ B.MEM(AS OF 10/23)/SECR.(AS OF 12/23) 1.00 X X 0 0 0 RAFAEL YEPEZ B.MEM(AS OF 9/23)/TREAS.(AS OF 12/23) 1.00 X X 0 0 0 CASSANDRA FEENEY ESQ SECR. (UNTIL 12/2023)/BOARD MEMBER 1.00 X 0 0 0 J RUSSELL CORCORAN MD BOARD MEMBER 1.00 X 0 0 0 EMILLIAN EGBUCHE BOARD MEMBER 1.00 X 0 0 0 N JOSEPH ESPAT MD BOARD MEMBER 1.00 X 0 0 0 MAYLEM ESTRELLA BOARD MEMBER (AS OF 12/2023) 1.00 X 0 0 0 RICHARD HEMPHILL BOARD MEMBER 1.00 X 0 0 0 YEISHA MERRARO BOARD MEMBER (AS OF 12/2023) 1.00 X 0 0 0 BYRON MONGE BOARD MEMBER (AS OF 7/2023) 1.00 X 0 0 0 WENDY THOMAS BOARD MEMBER 1.00 X 0 0 0 CHRISTINA ZANFAGNA BOARD MEMBER 1.00 X 0 0 0 MICHAEL CANCILLIERE BOARD MEMBER 1.00 X 0 0 0 ALTHEA GRAVES BOARD MEMBER (UNTIL 8/2023) 1.00 X 0 0 0 JOSEPH NAGLE BOARD MEMBER (UNTIL 8/2023) 1.00 X 0 0 0 MICHELLE ROSARIO BOARD MEMBER (UNTIL 1/2023) 1.00 X 0 0 0 MARY FRANCIS BISHOP RN BOARD MEMBER (UNTIL 12/2023) 1.00 X 0 0 0 MERRILL THOMAS PRESIDENT AND CEO 40.00 1.00 X 621513 0 29156 KEVIN CABRAL VP AND CFO 40.00 1.00 X 338097 0 21025 ANDREW SAAL VP AND CMO (UNTIL 6/2023) 40.00 X 422069 0 20693 KIMBERLY O'CONNELL VP AND CHIEF TRANSFORMATION OFFICER 40.00 X 361217 0 22769 CHERYL PERRY VP AND CHIEF HUMAN RESOURCES OFFICER 40.00 X 296539 0 14306 SUSANA CONKLIN VP AND CHIEF OF STAFF 40.00 X 249845 0 19359 JAY DECOSTA VP AND CIO 40.00 X 239803 0 18950 NADINE HEWAMUDALIGE VP AND CMO (AS OF 7/2023) 40.00 X 340262 0 21429 ALTUG KOYMEN MD OB/GYN 40.00 X 402291 0 23558 ANNE MURRAY MD OB/GYN 40.00 X 327035 0 21515 MANSI JAMES MD ASTHMA/ALLERGY 40.00 X 307579 0 21568 LIBERTAD THELMA FLORES MD OB/GYN 40.00 X 272030 0 20412 STANLEY BLOCK EMERITUS CMO 35.00 X 282129 0 27786 4460409 0 282526 131 0 1 0 CLOUDMED PO BOX 208272 DALLAS TX 753208272 CONSULTANT 656352 CASE CONSTRUCTION COMPANY 225 WAMPANOAG TRAIL EAST PROVIDENCE RI 02915 CONSTRUCTION CONTRACTOR 438701 DEAF TALK PO BOX 65 PEWAUKEE WI 53072 INTERPRETER SERVICES 374651 MAXIM HEALTHCARE STAFFING SERVICES 7227 LEE DEFOREST DRIVE COLUMBIA MD 21046 EMPLOYMENT AGENCY 286650 NEW ENGLAND CONSTRUCTION 293 BOURNE AVE RUMFORD RI 02916 CONSTRUCTION CONTRACTOR 267391 44 66300 21869945 14491803 36428048 PATIENT SERVICE REVENUE 621110 83478853 83478853 83478853 766806 766806 1571100 0 1571100 1571100 1571100 1475851 1287536 188315 188315 188315 45140 66300 48020 -2880 -2880 MISCELLANEOUS 621110 184132 184132 184132 122614374 83662985 0 2523341 161877 161877 3112022 3112022 52855447 45407348 7448099 2171803 1843009 328794 6877254 5568624 1308630 3794318 3048715 745603 361432 361432 104700 104700 3167009 1710761 1456248 18125 18125 1023991 651825 372166 4486090 3369255 1116835 358254 43136 315118 1452886 997247 455639 3712491 2357711 1354780 937455 521772 415683 MEDICAL SUPPLIES AND SE 8501383 8501383 LICENSES & FEES 4390230 4390230 DATA PROCESSING 4172964 3270374 902590 MISCELLANEOUS 481320 62771 418549 939877 467978 471899 103080928 82374016 20706912 0 11530369 22771105 177290 214778 16847076 26080205 2906055 4035935 9852462 9701514 622861 938183 95810652 33364049 44392779 62446603 10401894 11742976 32353503 18943262 129084289 156874561 6813714 7607114 8157727 7725379 15126004 23064080 31861357 16402895 61958802 54799468 X 67125487 101725093 350000 67125487 102075093 129084289 156874561 X 19533446 725640 898465 13792055 X X 0 1 X 1 1 1 X 12742364 20367282 15806369 22763178 24907618 96586811 12742364 20367282 15806369 22763178 24907618 96586811 96586811 621856 360721 340408 487255 2337906 4148146 522228 2118079 2490522 2508532 184132 7823493 108558450 354590030 0.88970 0.88860 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2019 AMOUNT: $ 522,228. 2020 AMOUNT: $ 2,118,079. 2021 AMOUNT: $ 2,490,522. 2022 AMOUNT: $ 2,508,532. 2023 AMOUNT: $ 184,132. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4250018 4250018 76425200 22148215 54276985 13699707 11063372 2636335 1435727 152462 1283265 62446603 RESTRICTED CASH 1484466 DEFERRED RENTAL REVENUE 30641 RIGHT-OF-USE ASSET - OPERATING 246743 RIGHT-OF-USE ASSET - FINANCE 14792455 ACCUMULATED UNREALIZED GAIN ON INTEREST RATE SWAP CONTRACTS 2347207 DUE FROM AFFILIATES 41750 18943262 FINANCE LEASE LIABILITY 16149435 OPERATING LEASE LIABILITY 253460 16402895 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 IN THE CONSOLIDATING FINANCIAL STATEMENTS AT DECEMBER 31, 2023. THE HEALTH CENTER'S INFORMATION RETURNS ARE SUBJECT TO EXAMINATION BY THE FEDERAL AND STATE JURISDICTIONS. GOLF TOURNAMENT 111440 66300 45140 909 18940 15568 12603 111440 66300 45140 909 18940 15568 12603 48020 -2880 1 PCHC ATWOOD INC 375 ALLENS AVE PROVIDENCE RI 02905 863765025 501C3 161877 0 OPERATING SUPPORT 1 PART I, LINE 2: AS PART OF THE NMTC DEAL, PCHC CONTRIBUTES TO PCHC ATWOOD ST WHEN THEY ARE IN NEED OF CASH. PCHC OPERATES THE FINANCIAL REPORTING FOR PCHC ATWOOD, INC. AND IS ABLE TO MONITOR WHEN CONTRIBUTIONS ARE NEEDED FROM PCHC AND HOW THEY ARE SPENT. X X 1 0 0 0 0 0 0 0 0 MERRILL THOMAS PRESIDENT AND CEO 534138 0 87375 0 0 0 22500 0 6656 0 650669 0 0 0 ANDREW SAAL VP AND CMO (UNTIL 6/2023) 208049 0 42461 0 171559 0 14037 0 6656 0 442762 0 0 0 ALTUG KOYMEN MD OB/GYN 346559 0 55732 0 0 0 16902 0 6656 0 425849 0 0 0 KIMBERLY O'CONNELL VP AND CHIEF TRANSFORMATION OFFICER 320998 0 40219 0 0 0 16113 0 6656 0 383986 0 0 0 NADINE HEWAMUDALIGE VP AND CMO (AS OF 7/2023) 315302 0 24960 0 0 0 14773 0 6656 0 361691 0 0 0 KEVIN CABRAL VP AND CFO 300222 0 37875 0 0 0 14369 0 6656 0 359122 0 0 0 ANNE MURRAY MD OB/GYN 294047 0 32988 0 0 0 14859 0 6656 0 348550 0 0 0 MANSI JAMES MD ASTHMA/ALLERGY 280473 0 27106 0 0 0 14912 0 6656 0 329147 0 0 0 CHERYL PERRY VP AND CHIEF HUMAN RESOURCES OFFICER 273079 0 23460 0 0 0 7650 0 6656 0 310845 0 0 0 STANLEY BLOCK EMERITUS CMO 279323 0 2806 0 0 0 21130 0 6656 0 309915 0 0 0 LIBERTAD THELMA FLORES MD OB/GYN 252587 0 19443 0 0 0 13756 0 6656 0 292442 0 0 0 SUSANA CONKLIN VP AND CHIEF OF STAFF 222001 0 27844 0 0 0 12703 0 6656 0 269204 0 0 0 JAY DECOSTA VP AND CIO 220147 0 19656 0 0 0 12294 0 6656 0 258753 0 0 0 PART I, LINE 4A ANDREW SAAL RECEIVED A SEVERANCE PAYMENT OF $171,559 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 4389621 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 4035935 0 1 1 4035935 MERRILL THOMAS CEO 1910621 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 27630000 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 113828 BOARD MEMBER OF FUNDING SOURCE, HEALTH CHOICE CARE. 0 MERRILL THOMAS CEO 50300 BOARD MEMBER OF FUNDING SOURCE. THE HEALTH CENTER RECEIVES GRANT FUNDING FROM RHODE ISLAND HEALTH CENTER ASSOCIATION. 0 FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION'S BYLAWS WERE AMENDED IN 2023. THE AMENDMENTS INCLUDED REWORDING THROUGHOUT THE DOCUMENT. SIGNIFICANT CHANGES WERE MADE TO THE BOARD OF DIRECTORS AND OFFICERS SECTION, THE COMMITTEES SECTION, AND THE CONFLICTS OF INTEREST SECTION. 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, UNIONIZED EMPLOYEES IS DETERMINED BASED UPON THE RESULTS OF BARGAINING UNIT NEGOTIATIONS. COMPENSATION FOR HOURLY NON-UNION, NON-EXEMPT AND SALARY NON-EXEMPT EMPLOYEES IS DETERMINED BASED UPON THE RESULTS OF MARKET STUDIES. 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 -430,042. CONTRIBUTION INCOME - MERGER 14,222,097. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PCHC BEAMAN AND SMITH MILL MASTER TENANT LLC (DISSOLVED 62023) 375 ALLENS AVE PROVIDENCE RI 02905 461430610 TO LEASE PROPERTY FROM PCHC BEAMAN AND SMITH MILL, LLC. RI 691024 0 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 1 B&S MILL INC (DISSOLVED 62023) 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 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 PCHC ATWOOD INC K 802037 FMV PCHC ATWOOD INC B 161877 FMV