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Nonprofiteer
← AMBOY MEDICAL PRACTICE PC

Form 990 for tax year 2022

Filed by AMBOY MEDICAL PRACTICE PC.

Totals

Total revenue
$34,113,825
Total expenses
$49,821,620
Contributions and grants received
$500,001
Grants paid
$0
Program service revenue
$33,854,189
Investment income
$0
Other revenue
-$240,365
Total assets, end of year
$10,416,496
Total liabilities, end of year
$81,423,692
Net assets or fund balances, end of year
-$71,007,196
Program services expenses (Part IX)
$43,530,849
Management and general expenses
$6,290,771
Fundraising expenses
$0
Program service expenses (Part III)
$43,530,849

Program services were 87.4% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1f · All other contributions, gifts and grants

    $500,001

  • 2a · Program service revenue: NET PATIENT SERVICE REVENUE

    total $33,387,180 · related or exempt $33,387,180

  • 2b · Program service revenue: OTHER HEALTHCARE RELATED REVENUE

    total $467,009 · related or exempt $467,009

  • 3 · Investment income

    total $0

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0

  • 5 · Royalties

    total $0

  • 6a · Gross rents

    real property $36,811

  • 6b · Less rental expenses

    real property $277,176

  • 6c · Rental income or loss

    real property -$240,365 · personal property $0

  • 6d · Net rental income or loss

    total -$240,365 · excluded -$240,365

  • 7d · Net gain or loss

    total $0

  • 8a · Fundraising events: gross income

    $0

  • 8b · Fundraising events: direct expenses

    $0

  • 8c · Net income from fundraising events

    total $0

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $0

  • 10c · Net income from sales of inventory

    total $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $0

  • 2 · Grants to domestic individuals

    total $0

  • 3 · Grants to foreign organizations and individuals

    total $0

  • 4 · Benefits paid to or for members

    total $0

  • 5 · Compensation of officers, directors and key employees

    total $0

  • 6 · Compensation of disqualified persons

    total $0

  • 7 · Other salaries and wages

    total $26,002,302 · program services $22,719,099 · management and general $3,283,203

  • 8 · Pension plan contributions

    total $0

  • 9 · Other employee benefits

    total $4,046,891 · program services $3,535,907 · management and general $510,984

  • 10 · Payroll taxes

    total $1,785,578 · program services $1,560,120 · management and general $225,458

  • 11a · Fees: management

    total $0

  • 11b · Fees: legal

    total $0

  • 11c · Fees: accounting

    total $0

  • 11d · Fees: lobbying

    total $0

  • 11e · Fees: professional fundraising services

    total $0

  • 11f · Fees: investment management

    total $0

  • 11g · Fees: other

    total $4,589,213 · program services $4,009,752 · management and general $579,461 · fundraising $0

  • 12 · Advertising and promotion

    total $3,368 · program services $2,943 · management and general $425

  • 13 · Office expenses

    total $332,627 · program services $290,628 · management and general $41,999

  • 14 · Information technology

    total $8,163 · program services $7,132 · management and general $1,031

  • 15 · Royalties

    total $0

  • 16 · Occupancy

    total $1,937,844 · program services $1,693,160 · management and general $244,684

  • 17 · Travel

    total $1,741 · program services $1,521 · management and general $220

  • 18 · Travel or entertainment for public officials

    total $0

  • 19 · Conferences, conventions and meetings

    total $13,339 · program services $11,655 · management and general $1,684

  • 20 · Interest

    total $0

  • 21 · Payments to affiliates

    total $0

  • 22 · Depreciation, depletion and amortization

    total $901,393 · program services $787,578 · management and general $113,815

  • 23 · Insurance

    total $3,046,805 · program services $2,662,097 · management and general $384,708

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $1,074,714 · program services $939,014 · management and general $135,700 · fundraising $0

  • 24b · Other expenses: REPAIRS & MAINTENANCE

    total $690,868 · program services $603,635 · management and general $87,233 · fundraising $0

  • 24c · Other expenses: DUES & SUBSCRIPTIONS

    total $20,932 · program services $18,289 · management and general $2,643 · fundraising $0

  • 24d · Other expenses: OTHER EXPENSES

    total $5,365,842 · program services $4,688,319 · management and general $677,523 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $3,600 · end of year $3,600

  • 2 · Savings and temporary cash investments

    beginning of year $2,188,702 · end of year $3,161,343

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $2,383,039 · end of year $2,167,010

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $13,688 · end of year $20,501

  • 10a · Land, buildings and equipment: cost or other basis

    $10,221,657

  • 10b · Land, buildings and equipment: accumulated depreciation

    $6,312,492

  • 10c · Land, buildings and equipment, net

    beginning of year $4,089,600 · end of year $3,909,165

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0 · end of year $0

  • 13 · Investments: program-related

    beginning of year $0 · end of year $0

  • 14 · Intangible assets

    beginning of year $1,308,839 · end of year $1,121,862

  • 15 · Other assets

    beginning of year $33,015 · end of year $33,015

  • 17 · Accounts payable and accrued expenses

    beginning of year $2,268,698 · end of year $2,581,954

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $1,474,613 · end of year $1,353,947

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $61,576,573 · end of year $77,487,791

  • 27 · Net assets without donor restrictions

    beginning of year -$55,299,401 · end of year -$71,007,196

  • 28 · Net assets with donor restrictions

    beginning of year $0 · end of year $0

Mission and programs · 2022

Mission

AMBOY MEDICAL PRACTICE, P.C. IS AN INTERNAL REVENUE CODE SECTION 501(C)(3) NOT-FOR-PROFIT CORPORATION THROUGH WHICH EMPLOYED PHYSICIANS PROVIDE PRIMARY CARE, SPECIALTY CARE, AND BEHAVIORAL HEALTH SERVICES IN A VARIETY OF SETTINGS INCLUDING CLINICS AND OFFICE BASED FACILITIES. THIS ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. FOR ADDITIONAL INFORMATION, PLEASE REFER TO THE ORGANIZATION'S STATEMENT OF PROGRAM SERVICES INCLUDED WITHIN SCHEDULE O.

Activities or mission (Part I)

THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF RICHMOND MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION.

  • EXPENSES INCURRED IN PROVIDING PRIMARY CARE, SPECIALTY CARE AND BEHAVIORAL HEALTH SERVICES IN FURTHERANCE OF THE SYSTEM'S CHARITABLE TAX-EXEMPT PURPOSES. FOR ADDITIONAL INFORMATION PLEASE REFER TO THE STATEMENT OF PROGRAM SERVICES INCLUDED WITHIN SCHEDULE O.

    Expenses $43,530,849 · Revenue $33,854,189

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Inna Tubman MD

    OBGYN

    Total calculated
    $1,509,186
    From this org
    $1,450,749
    From related orgs
    $0
    Other
    $58,437
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $553,446
    Bonus
    $896,870
    Other
    $433
    Deferred
    $21,350
    Nontaxable benefits
    $37,087
    Filer's total
    $1,509,186

  • Simon G Kokkinakis MD

    OBGYN

    Total calculated
    $829,835
    From this org
    $773,552
    From related orgs
    $0
    Other
    $56,283
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $753,000
    Bonus
    $20,000
    Other
    $552
    Deferred
    $21,350
    Nontaxable benefits
    $34,933
    Filer's total
    $829,835

  • Michael H Campanella MD

    OBGYN

    Total calculated
    $764,067
    From this org
    $717,971
    From related orgs
    $0
    Other
    $46,096
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $707,133
    Bonus
    $10,424
    Other
    $414
    Deferred
    $21,350
    Nontaxable benefits
    $24,746
    Filer's total
    $764,067

  • Alexander Beylinson Do

    DIRECTOR - PRESIDENT

    Total calculated
    $673,446
    From this org
    $0
    From related orgs
    $632,508
    Other
    $40,938
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $190,877 related
    Bonus
    $0 + $441,199 related
    Other
    $0 + $432 related
    Deferred
    $0 + $13,737 related
    Nontaxable benefits
    $0 + $27,201 related
    Filer's total
    $0 + $673,446 related

  • Richard Maggio MD

    UROLOGIST

    Total calculated
    $609,779
    From this org
    $551,342
    From related orgs
    $0
    Other
    $58,437
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $385,772
    Bonus
    $159,205
    Other
    $6,365
    Deferred
    $21,350
    Nontaxable benefits
    $37,087
    Filer's total
    $609,779

  • Richard Salhany MBA Fache

    CHIEF ADMINISTRATION OFFICER

    Total calculated
    $608,664
    From this org
    $0
    From related orgs
    $513,122
    Other
    $95,542
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $506,012 related
    Bonus
    $0
    Other
    $0 + $7,110 related
    Deferred
    $0 + $57,248 related
    Nontaxable benefits
    $0 + $38,294 related
    Filer's total
    $0 + $608,664 related

  • David Murray MBA Fhfma

    SVP, CFO

    Total calculated
    $591,728
    From this org
    $0
    From related orgs
    $498,897
    Other
    $92,831
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $497,703 related
    Bonus
    $0
    Other
    $0 + $1,194 related
    Deferred
    $0 + $55,744 related
    Nontaxable benefits
    $0 + $37,087 related
    Filer's total
    $0 + $591,728 related

  • Christopher V Lisi MD

    OTOLARYNGOLOGIST

    Total calculated
    $571,609
    From this org
    $550,259
    From related orgs
    $0
    Other
    $21,350
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $536,333
    Bonus
    $0
    Other
    $13,926
    Deferred
    $21,350
    Nontaxable benefits
    $0
    Filer's total
    $571,609

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

SCHEDULE J, PART I; QUESTION 4B
THE AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN B(III) FOR THE FOLLOWING INDIVIDUAL INCLUDES A CURRENT YEAR VESTING IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THIS AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNT OUTLINED HEREIN WAS INCLUDED IN THE INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: RICHARD SALHANY, MBA, FACHE, $3,683. THE DEFERRED COMPENSATION AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDE UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH IS SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THESE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: RICHARD SALHANY, MBA, FACHE, $23,698 AND DAVID MURRAY, MBA, FHFMA, $22,194.
SCHEDULE J, PART I; QUESTION 7
CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2022 WHICH WAS INCLUDED IN SCHEDULE J, PART II, COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.
SCHEDULE J, PART II; COLUMN F
THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) INCLUDES VESTED BENEFITS IN A DEFERRED COMPENSATION PLAN AS THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THIS AMOUNT WAS REPORTED AS DEFERRED COMPENSATION ON PRIOR YEARS' FORMS 990 AND IS NOW BEING REPORTED AGAIN ON THIS YEAR'S FORM 990. THIS HAS BEEN TREATED AS TAXABLE INCOME AND REPORTED ON THE INDIVIDUAL'S FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • BRIDGE REGIONAL HEALTH SYSTEM

    C CORP · HOLDING COMPANY · NY

    Directly controlled by NA

  • HEALTH WATCH-LIFELINE INC

    C CORP. · INACTIVE · NY

    Directly controlled by NA

Provenance

Return type
form_990
Tax year
2022
Filed
7 November 2023
IRS schema version
2022v5.0
Source object
202333179349304303

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