2024-02-27T23:35:53-06:00 2023-06-30 221478099 COHNREZNICK LLP 350 CHURCH STREET 12TH FLOOR HARTFORD CT 06103 990 2022-07-01 223160873 STAYWELL HEALTH CARE INC STAY 2037568021 80 PHOENIX AVENUE 201 WATERBURY CT 06702 DONALD J THOMPSON JR CHIEF EXECUTIVE OFFICER 2037568021 2024-02-26 1 DONALD THOMPSON JR 999009999 1 LORI ROTHE YOKOBOSKY CPA P01273422 9592007000 2024-01-23 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DONALD J THOMPSON JR 80 PHOENIX AVENUE 201 WATERBURY CT 06702 38484556 0 X WWW.STAYWELLHEALTH.ORG X 1992 CT PROVIDE PRIMARY HEALTH CARE, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES, TO THE UNDERSERVED POPULATION OF THE GREATER WATERBURY COMMUNITY. 11 11 309 17 0 0 13740694 16084759 22088517 22071394 9482 -360724 231286 264358 36069979 38059787 0 0 0 0 22179213 23612489 0 0 0 10987512 11855402 33166725 35467891 2903254 2591896 17651255 20478449 4620696 4853515 13030559 15624934 PROVIDE PRIMARY HEALTH CARE, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES, TO THE UNDERSERVED POPULATION OF THE GREATER WATERBURY COMMUNITY. 0 0 28753809 22310524 MEDICAL CLINIC, HEALTHY START, AND DENTAL CLINIC WHICH PROVIDE MEDICAL, PRENATAL, AND CHILDCARE FOR INNER CITY RESIDENTS AND UNINSURED RESIDENTS AND RESTORATIVE DENTAL CARE FOR INNER CITY CHILDREN. THE TOTAL NUMBER OF VISITS DURING FISCAL YEAR 2023 WAS 107,658. 28753809 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 0 0 0 1 0 0 0 0 0 0 0 0 1 110 0 1 309 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 0 0 CT X LULE TRACEY 2037568021 80 PHOENIX AVENUE SUITE 201 WATERBURY CT 06702 ASHLEY LAMB BOARD MEMBER 0.75 X 0 0 0 CAROLYN HIGHSMITH TREASURER 0.75 X X 0 0 0 CYNTHIA HALL BOARD MEMBER 0.75 X 0 0 0 ELIZABETH BURGOS BOARD MEMBER 0.75 X 0 0 0 MARK BRIGGS CHAIRPERSON 0.75 X X 0 0 0 PAULETTE CUOZZO BOARD MEMBER 0.75 X 0 0 0 RANDY GEARY BOARD MEMBER 0.75 X 0 0 0 ROBERT LANEY BOARD MEMBER 0.75 X 0 0 0 SANDRA SOREL-LEDUC VICE-CHAIR 0.75 X X 0 0 0 WANDA DUNBAR BOARD MEMBER 0.75 X 0 0 0 YOHALY SOTO BOARD MEMBER 0.75 X X 0 0 0 ALISON CAMPBELL SECRETARY 0.75 X 0 0 0 DONALD THOMPSON CEO 40.00 X 285941 0 75604 LULE TRACEY CFO 40.00 X 244186 0 53331 AMIT PATEL DDS DENTAL DIRECTOR 40.00 X 260512 0 91155 CHRISTINE BIANCHI CHIEF DEVELOPMENT OFFICER 40.00 X 185230 0 78810 TESS LOMBARD MD CMO 40.00 X 324521 0 92708 ALISON GROVER PHYSICIAN 40.00 X 212353 0 36473 ELIE HELOU PHYSICIAN 40.00 X 242078 0 41606 JILL BERNSTEIN PHYSICIAN 40.00 X 215154 0 37073 MIGUEL MANTILLA-VILLAMIZAR PHYSICIAN 40.00 X 211777 0 51949 STEPHEN SPEAR PHYSICIAN 40.00 X 225313 0 39647 2407065 0 598356 31 0 1 0 WELLMORE INC 141 E MAIN STREET WATERBURY CT 06702 BEHAVIORIAL HEALTH - OASIS CLINICAL SERV 814491 ALLEHEALTH SERVICES 13127 KINGS LAKE DRIVE 102 GIBSONTON FL 33534 ALLERGY TESTING SERVICES TO OUR PATIENTS 561260 WATERBURY HOSPITAL 64 ROBBINS ST WATERBURY CT 06708 INFECTIOUS DISEASE, CARDIOLOGIST, BH 158278 UCONN HEALTH CENTER 263 FARMINGTON AVE FARMINGTON CT 06030 PEDIATRIC DENTISTRY SERVICES 119762 GEMINI DENTAL LABORATORY LLC 2580 PORTER ST SUITE 73 WATERTOWN CT 06795 LAB SERVICES 115561 5 38974 15317861 727924 1085527 16084759 MEDICAID 621400 12975798 12975798 PHARMACY 340B 621400 5974102 5974102 THIRD-PARTY PAYORS 621400 1412102 1412102 MEDICARE 621400 1173378 1173378 SELF-PAY PATIENTS 621400 536014 536014 22071394 64045 64045 25228 0 25228 25228 25228 424769 -424769 -424769 -424769 INCENTIVE PAYMENTS 900099 239130 239130 239130 38059787 22310524 0 -335496 X 1691397 1361331 330066 16147385 14532647 1614738 1635161 730132 905029 2838495 1267444 1571051 1300051 1170046 130005 81587 81587 86337 86337 4257083 2974331 1282752 48147 43537 4610 35202 31832 3370 789629 714062 75567 642691 581160 61531 33882 30638 3244 78484 70970 7514 304898 275707 29191 179178 162023 17155 PROG. ACTIVITIES, SUPPL 3221258 2822621 398637 DONATED VACCINES/MEDICA 1085527 1085527 EQUIPMENTAL RENTAL AND 246738 223115 23623 DUES AND SUBSCRIPTIONS 91594 82825 8769 673167 593861 79306 35467891 28753809 6714082 0 4587884 5313673 4279248 4284697 929407 1073797 2567609 3251602 230502 648695 9967728 4788557 4223279 5179171 31217 34421 108333 108333 693776 584060 17651255 20478449 1828026 1864821 798362 687157 1994308 2301537 4620696 4853515 X 13030559 15624934 13030559 15624934 17651255 20478449 2591896 2479 0 X 0 1 X 1 1 1 X 7803540 7319281 11741183 13740694 16084759 56689457 7803540 7319281 11741183 13740694 16084759 56689457 56689457 63678 71933 39074 38521 89273 302479 125509 75901 110368 220159 239130 771067 57763003 98569584 0.98140 0.98240 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MEANINGFUL USE INCENTIVE - 2018 AMOUNT: $ 68,596. 2019 AMOUNT: $ 47,196. 2020 AMOUNT: $ 104,185. 2021 AMOUNT: $ 213,131. 2022 AMOUNT: $ 239,130. MISCELLANEOUS - 2018 AMOUNT: $ 56,913. 2019 AMOUNT: $ 28,705. 2020 AMOUNT: $ 6,183. 2021 AMOUNT: $ 7,028. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 384297 384297 8129065 3570393 4558672 1454366 1218164 236202 5179171 ACCRUED PROFIT SHARING 1721067 SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN 580470 2301537 X 38062266 2479 2479 38059787 0 38059787 35467891 0 35467891 0 35467891 PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT, AS OF JUNE 30, 2023 AND 2022, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRES RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PROPER TO FISCAL YEAR 2020 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATED EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. X X X 0 1 0 0 0 0 0 1 0 TESS LOMBARD MD CMO 321166 0 3289 0 66 0 55300 0 37408 0 417229 0 0 0 DONALD THOMPSON CEO 279411 0 0 0 6530 0 61800 0 13804 0 361545 0 0 0 AMIT PATEL DDS DENTAL DIRECTOR 260446 0 0 0 66 0 54765 0 36390 0 351667 0 0 0 LULE TRACEY CFO 244120 0 0 0 66 0 51717 0 1614 0 297517 0 0 0 ELIE HELOU PHYSICIAN 239288 0 2724 0 66 0 28672 0 12934 0 283684 0 0 0 STEPHEN SPEAR PHYSICIAN 223132 0 2138 0 43 0 26356 0 13291 0 264960 0 0 0 CHRISTINE BIANCHI CHIEF DEVELOPMENT OFFICER 185164 0 0 0 66 0 43440 0 35370 0 264040 0 0 0 MIGUEL MANTILLA-VILLAMIZAR PHYSICIAN 202504 0 9207 0 66 0 24048 0 27901 0 263726 0 0 0 JILL BERNSTEIN PHYSICIAN 213118 0 1970 0 66 0 25333 0 11740 0 252227 0 0 0 ALISON GROVER PHYSICIAN 209007 0 3303 0 43 0 24740 0 11733 0 248826 0 0 0 PART I, LINE 4B PART I, LINE 4B: THE FOLLOWING INDIVIDUALS PARTICIPATE IN 457(F) PLAN: - DONALD J. THOMPSON, JR., CEO - LULE TRACEY, CFO - AMIT PATEL, DENTAL DIRECTOR PART I, LINE 7 THE CENTER PROVIDED AN ANNUAL BOARD APPROVED PROFIT SHARING BONUS. X 2 1085527 FMV 0 1 0 PART I, COLUMN (B): COLUMN B REPRESENTS NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE REVIEWED AND ACCEPTED BY THE BOARD BEFORE STAYWELL SUBMITS. FORM 990, PART VI, SECTION B, LINE 12C DONALD THOMPSON, CEO, MONITORS CONFLICT OF INTEREST POLICY BY REVIEWING AND ADDRESSING ANY POTENTIAL CONFLICTS AND FOLLOWING UP EACH YEAR FOR ANY CHANGES. BOARD MEMBERS ARE REQUIRED TO SIGN THE POLICY ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15A INFORMATION FROM NATIONAL AND STATEWIDE SURVEYS ARE USED AS CRITERIA TO DETERMINE THE SALARY OF THE CEO. THIS INFORMATION IS GIVEN TO THE PERSONNEL COMMITTEE FOR REVIEW. THE PERSONNEL COMMITTEE NEGOTIATES AND APPROVES THE SALARY OF THE CEO. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL CONSULTANTS: PROGRAM SERVICE EXPENSES 1,951,983. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,951,983. OTHER CONSULTANTS: PROGRAM SERVICE EXPENSES 454,030. MANAGEMENT AND GENERAL EXPENSES 1,282,752. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,736,782. PHARMACY CONSULTANTS: PROGRAM SERVICE EXPENSES 420,344. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 420,344. LAB CONSULTANTS: PROGRAM SERVICE EXPENSES 147,974. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 147,974.