2025-11-14T08:55:00-06:00 2024-12-31 042571780 AAFCPAS INC 50 WASHINGTON STREET WESTBOROUGH MA 01581 990 2024-01-01 050368134 THE PROVIDENCE COMMUNITY HEALTH CENTERS INC PROV 4014440400 375 ALLENS AVENUE PROVIDENCE RI 029055010 MERRILL THOMAS CEO 4014440400 2025-11-11 1 1 CAITLIN LIMOGES CPA P01633588 5083669100 2025-11-11 2024 2025-03-06 01:10:19Z MERRILL THOMAS 375 ALLENS AVENUE PROVIDENCE RI 029055010 91695409 0 X WWW.PROVIDENCECHC.ORG X 1976 RI TO IMPROVE THE WELL-BEING OF THE COMMUNITIES WE SERVE THROUGH THE DELIVERY OF HIGH-QUALITY, ACCESSIBLE, AND AFFORDABLE HEALTHCARE FOR ALL, REGARDLESS OF A PERSON'S ABILITY TO PAY. 13 13 833 35 0 0 36428048 12640793 83478853 73150393 955121 1518650 1752352 1392316 122614374 88702152 161877 0 0 0 68810844 69451644 0 0 0 34108207 36248996 103080928 105700640 19533446 -16998488 156874561 134530066 54799468 52661442 102075093 81868624 TO IMPROVE THE WELL-BEING OF THE COMMUNITIES WE SERVE THROUGH THE DELIVERY OF HIGH-QUALITY, ACCESSIBLE, AND AFFORDABLE HEALTHCARE FOR ALL, REGARDLESS OF A PERSON'S ABILITY TO PAY. 0 0 67096361 49814209 PATIENT SERVICEPROVISION OF PRIMARY HEALTH CARE TO RESIDENTS IN PROVIDENCE ALSO PROVIDING SPECIALIZED CARE AT 13 SITES IN PROVIDENCE. IN FY24, WE SERVED OVER 64,700 PATIENTS WITH OVER 268,200 PATIENT VISITS. 4306058 5462240 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 FY24, WE SERVED 12,000 PATIENTS WITH 25,200 PATIENT VISITS. 12509990 18070501 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 FY24 THERE WERE 52,666 PATIENTS UTILIZING CONTRACT PHARMACY AND 416,055 PRESCRIPTIONS SENT TO CONTRACT PHARMACY. 83912409 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 0 0 1 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 45 0 1 833 1 0 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 RI X KEVIN CABRAL CHIEF FINANCIAL OFFICER 4014440400 375 ALLENS AVENUE PROVIDENCE RI 029055010 AMBER BICHUN VICE CHAIR 1.00 0.10 X X 0 0 0 CARL BROWN CHAIRMAN (UNTI 10/24)/BOARD MEMBER (UNTIL 12/24) 1.00 X X 0 0 0 MEGHAN HOPKINS ESQ SECRETARY 1.00 X X 0 0 0 RAFAEL YEPEZ TREASURER 1.00 X X 0 0 0 MICHAEL CANCILLIERE BOARD MEMBER/CHAIR (AS OF 11/24) 1.00 X X 0 0 0 J RUSSELL CORCORAN MD BOARD MEMBER 1.00 X 0 0 0 N JOSEPH ESPAT MD BOARD MEMBER 1.00 X 0 0 0 MAYLEEM ESTRELLA BOARD MEMBER (UNTIL 8/2024) 1.00 X 0 0 0 RICHARD HEMPHILL BOARD MEMBER 1.00 X 0 0 0 YEISHA MERRARO BOARD MEMBER (UNTIL 7/2024) 1.00 X 0 0 0 BYRON MONGE BOARD MEMBER 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 CASSANDRA FEENEY ESQ BOARD MEMBER 1.00 X 0 0 0 PATRICIA HARMON RN BSN MM CPHRM BOARD MEMBER (AS OF 1/2024) 1.00 X 0 0 0 EMILLIAN EGBUCHE BOARD MEMBER (UNTIL 5/2024) 1.00 X 0 0 0 JOSEFA DOUGLAS BOARD MEMBER (5/24 - 8/24) 1.00 X 0 0 0 ROSANNA SUERO BOARD MEMBER (8/24 - 9/24) 1.00 X 0 0 0 MERRILL THOMAS PRESIDENT AND CEO 40.00 1.00 X 661692 0 29253 KEVIN CABRAL VP AND CFO 40.00 1.00 X 358009 0 23480 NADINE HEWAMUDALIGE VP AND CMO 40.00 X 400264 0 23993 KIMBERLY O'CONNELL VP & CHIEF TRANSFORMATION OFFICER 40.00 X 380803 0 24875 CHERYL PERRY VP & CHIEF HUMAN RESOURCES OFFICER 40.00 X 320302 0 18755 JAY DECOSTA VP AND CIO (UNTIL 8/2024) 40.00 X 274949 0 18147 SUSANA CONKLIN VP AND CHIEF OF STAFF 40.00 X 264229 0 22008 ALTUG KOYMEN MD OB/GYN 40.00 X 411201 0 25803 MANSI JAMES MD ASTHMA/ALLERGY 40.00 X 321651 0 23465 ANH-TAI DANG MD OB/GYN 40.00 X 327682 0 22913 STANLEY BLOCK EMERITUS CMO 35.00 X 289516 0 30853 VINOD THOMAS MD INTERNAL MEDICINE 40.00 X 296762 0 19837 4307060 0 283382 187 0 1 0 CASE CONSTRUCTION COMPANY 225 WAMPANOAG TRAIL EAST PROVIDENCE RI 02915 CONSTRUCTION CONTRACTOR 2682338 USENTRA SECURITY SERVICES 100 DUPONT DRIVE PROVIDENCE RI 02915 SECURITY SERVICES 727758 DEAF TALK PO BOX 65 PEWAUKEE WI 53072 INTERPRETER SERVICES 643690 CLOUDMED PO BOX 208272 DALLAS TX 753208272 340B REFERRAL SERVICES 576246 MAXIM HEALTHCARE STAFFING SERVICES 7227 LEE DEFOREST DRIVE COLUMBIA MD 21046 EMPLOYMENT AGENCY 431886 13 70410 8728197 3842186 12640793 PATIENT SERVICE REVENUE 621110 56096861 56096861 PHARMACY REVENUE 621110 17053532 17053532 73150393 1048419 1048419 1204057 0 1204057 1204057 1204057 3402164 2931933 470231 470231 470231 53026 70410 61324 -8298 -8298 MISCELLANEOUS 621110 196557 196557 196557 88702152 73346950 0 2714409 2149218 2149218 52857388 43137699 9719689 2254589 1809757 444832 8313880 6434388 1879492 3876569 2978754 897815 357830 357830 210402 210402 1952855 993932 958923 492 361 131 966840 601819 365021 3919260 2741002 1178258 338175 27321 310854 1562720 1072636 490084 4001713 2643332 1358381 1149203 651781 497422 MEDICAL SUPPLIES AND SE 11208161 11208161 LICENSES & FEES 4203633 4203633 ELECTRONIC HEALTH RECOR 3583838 3583838 DATA PROCESSING 1660880 1306319 354561 1132994 517676 615318 105700640 83912409 21788231 0 22771105 9669991 214778 426302 26080205 13750327 4035935 5129281 9701514 9623300 938183 1146456 100773347 36778785 62446603 63994562 11742976 13118229 18943262 17671618 156874561 134530066 7607114 6590845 7725379 7279213 23064080 22475112 16402895 16316272 54799468 52661442 X 101725093 81304094 350000 564530 102075093 81868624 156874561 134530066 X -16998488 617694 -3825675 X X 0 1 X 1 1 1 X 20367282 15806369 22763178 24907618 12640793 96485240 20367282 15806369 22763178 24907618 12640793 96485240 96485240 360721 340408 487255 2337906 2252476 5778766 2118079 2490522 2508532 184132 196557 7497822 109761828 366220476 0.87900 0.88970 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2020 AMOUNT: $ 2,118,079. 2021 AMOUNT: $ 2,490,522. 2022 AMOUNT: $ 2,508,532. 2023 AMOUNT: $ 184,132. 2024 AMOUNT: $ 196,557. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4725676 4725676 78197312 24544925 53652387 15126161 12057188 3068973 2724198 176672 2547526 63994562 RESTRICTED CASH 911796 DEFERRED RENT RECEIVABLE 83574 RIGHT-OF-USE ASSET - OPERATING 2420 RIGHT-OF-USE ASSET - FINANCE 14205478 ACCUMULATED UNREALIZED GAIN ON INTEREST RATE SWAP CONTRACTS 2468350 17671618 FINANCE LEASE LIABILITIES 16307420 OPERATING LEASE LIABILITY 8852 16316272 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, 2024. THE HEALTH CENTER'S INFORMATION RETURNS ARE SUBJECT TO EXAMINATION BY THE FEDERAL AND STATE JURISDICTIONS. GOLF TOURNAMENT 123436 70410 53026 2606 23438 21146 14134 123436 70410 53026 2606 23438 21146 14134 61324 -8298 X X 1 0 0 0 0 0 0 0 0 MERRILL THOMAS PRESIDENT AND CEO 545292 0 109200 0 7200 0 20700 0 8553 0 690945 0 0 0 ALTUG KOYMEN MD OB/GYN 359039 0 52162 0 0 0 17250 0 8553 0 437004 0 0 0 NADINE HEWAMUDALIGE VP AND CMO 353171 0 47093 0 0 0 15440 0 8553 0 424257 0 0 0 KIMBERLY O'CONNELL VP & CHIEF TRANSFORMATION OFFICER 330103 0 50700 0 0 0 16322 0 8553 0 405678 0 0 0 KEVIN CABRAL VP AND CFO 311209 0 46800 0 0 0 14927 0 8553 0 381489 0 0 0 ANH-TAI DANG MD OB/GYN 299253 0 28429 0 0 0 14360 0 8553 0 350595 0 0 0 MANSI JAMES MD ASTHMA/ALLERGY 290758 0 30893 0 0 0 14912 0 8553 0 345116 0 0 0 CHERYL PERRY VP & CHIEF HUMAN RESOURCES OFFICER 280522 0 39780 0 0 0 10202 0 8553 0 339057 0 0 0 STANLEY BLOCK EMERITUS CMO 288766 0 750 0 0 0 22300 0 8553 0 320369 0 0 0 VINOD THOMAS MD INTERNAL MEDICINE 258506 0 38256 0 0 0 11284 0 8553 0 316599 0 0 0 JAY DECOSTA VP AND CIO (UNTIL 8/2024) 167776 0 21673 0 85500 0 9594 0 8553 0 293096 0 0 0 SUSANA CONKLIN VP AND CHIEF OF STAFF 229129 0 35100 0 0 0 13455 0 8553 0 286237 0 0 0 PART I, LINE 4A JAY DECOSTA RECEIVED A SEVERANCE PAYMENT IN 2024. 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 4835787 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 14.000000000000 0 0 0 0 1 A 1 MERRILL THOMAS PRESIDENT & CEO SPLIT-DOLLAR LIFE INSURANCE PLAN X 968685 5129281 0 1 1 5129281 MERRILL THOMAS CEO 3859018 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 13093000 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 216187 BOARD MEMBER OF FUNDING SOURCE, HEALTH CHOICE CARE. 0 MERRILL THOMAS CEO 43700 BOARD MEMBER OF FUNDING SOURCE. THE HEALTH CENTER RECEIVES GRANT FUNDING FROM RHODE ISLAND HEALTH CENTER ASSOCIATION. 0 MERRILL THOMAS CEO 25000 THE CEO SERVES ON THE BOD OF NACHC, WHICH THE HEALTH CENTER PAYS MEMBERSHIP DUES. 0 MERRILL THOMAS CEO 35547 BOARD MEMBER OF FUNDING SOURCE. THE HEALTH CENTER PAID ORGANIZATIONAL DUES TO THE RHODE ISLAND HEALTH CENTER ASSOCIATION. 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, 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 121,143. EMPLOYEE RETENTION RESERVE -3,946,818. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 PCHC ATWOOD INC K 802037 FMV