TY 2017 Form 990 Schedule O

efile Public Visual Render ObjectId: 201823179349303342 - Submission: 2018-11-13 TIN: 46-2690306

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
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Attach to Form 990 or 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2017

Open to Public
Inspection

Name of the organization

AJS BROOKLYN MEDICAL PRACTICE PC

Employer identification number

46-2690306

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 3	AJS MED PRACTICE (AJS) DELEGATES A NUMBER OF ADMINISTRATIVE/ MANAGEMENT ACTIVITIES TO ITS PARENT, AIDS HEALTHCARE FOUNDATION ("AHF") . SUCH FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO SUPPORT FOR PAYROLL, OFFICE MANAGEMENT, FINANCIAL OPERATIONS, MANAGEMENT INFORMATION SYSTEMS, BILLING, CREDENTIALING AND MARKETING.
FORM 990, PART VI, SECTION A, LINE 6	AIDS HEALTHCARE FOUNDATION IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	AIDS HEALTHCARE FOUNDATION, THE SOLE MEMBER OF THE ORGANIZATION HAS THE POWER TO APPOINT AND REMOVE DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	AIDS HEALTHCARE FOUNDATION, THE SOLE MEMBER OF THE ORGANIZATION HAS THE POWER TO APPOINT DIRECTORS AND APPROVE THEIR REMOVAL.
FORM 990, PART VI, SECTION B, LINE 11B	AJS'S OUTSIDE AUDITORS AND THE PARENT ORGANIZATION'S (AHF'S) FINANCE PERSONNEL PREPARE FORM 990. THE FORM IS THEN REVIEWED AND APPROVED BY AHF'S CONTROLLER AND CHIEF FINANCIAL OFFICER. THE FORM IS THEN SENT TO THE AHF AUDIT COMMITTEE, WHICH IS COMPOSED OF BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION REQUIRES ALL EMPLOYEES TO DISCLOSE, AT LEAST ANNUALLY, ALL SOURCES OF INCOME FROM COMPENSATION OR FROM OWNERSHIP OF EVERY OUTSIDE ENTITY THAT (A) SOLD, SUPPLIED OR PROVIDED SERVICES (B) OPERATED A COMPETING ENTERPRISE OR (C) PROVIDED GOODS OR SERVICES TO THE ORGANIZATION IN THE LAST SIX MONTHS. THE ORGANIZATION ALSO REQUIRES ALL DIRECTORS TO ANNUALLY SIGN A STATEMENT AFFIRMING (A) RECEIPT OF THE ORGANIZATION CONFLICT OF INTEREST POLICY (B) UNDERSTANDING OF THE POLICY AND (C) AGREEMENT WITH THE POLICY. THE ORGANIZATION CONFLICT OF INTEREST POLICY DESCRIBES HOW THE ORGANIZATION WILL RESOLVE POSSIBLE CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD REVIEWED AJS MEDICAL DIRECTOR'S COMPENSATION IN 2016. THE BOARD REVIEWED DATA OF COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED NONPROFIT EXECUTIVES. THE OCCURRENCE OF THESE DELIBERATIONS ARE NOTED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19	SOME OR ALL OF THESE ITEMS MAYBE AVAILABLE UPON REQUEST.

Return Reference

Explanation

FORM 990, PART VI, SECTION A, LINE 3

AJS MED PRACTICE (AJS) DELEGATES A NUMBER OF ADMINISTRATIVE/ MANAGEMENT ACTIVITIES TO ITS PARENT, AIDS HEALTHCARE FOUNDATION ("AHF") . SUCH FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO SUPPORT FOR PAYROLL, OFFICE MANAGEMENT, FINANCIAL OPERATIONS, MANAGEMENT INFORMATION SYSTEMS, BILLING, CREDENTIALING AND MARKETING.

FORM 990, PART VI, SECTION A, LINE 6

AIDS HEALTHCARE FOUNDATION IS THE SOLE MEMBER OF THE ORGANIZATION.

FORM 990, PART VI, SECTION A, LINE 7A

AIDS HEALTHCARE FOUNDATION, THE SOLE MEMBER OF THE ORGANIZATION HAS THE POWER TO APPOINT AND REMOVE DIRECTORS.

FORM 990, PART VI, SECTION A, LINE 7B

AIDS HEALTHCARE FOUNDATION, THE SOLE MEMBER OF THE ORGANIZATION HAS THE POWER TO APPOINT DIRECTORS AND APPROVE THEIR REMOVAL.

FORM 990, PART VI, SECTION B, LINE 11B

AJS'S OUTSIDE AUDITORS AND THE PARENT ORGANIZATION'S (AHF'S) FINANCE PERSONNEL PREPARE FORM 990. THE FORM IS THEN REVIEWED AND APPROVED BY AHF'S CONTROLLER AND CHIEF FINANCIAL OFFICER. THE FORM IS THEN SENT TO THE AHF AUDIT COMMITTEE, WHICH IS COMPOSED OF BOARD MEMBERS.

FORM 990, PART VI, SECTION B, LINE 12C

THE ORGANIZATION REQUIRES ALL EMPLOYEES TO DISCLOSE, AT LEAST ANNUALLY, ALL SOURCES OF INCOME FROM COMPENSATION OR FROM OWNERSHIP OF EVERY OUTSIDE ENTITY THAT (A) SOLD, SUPPLIED OR PROVIDED SERVICES (B) OPERATED A COMPETING ENTERPRISE OR (C) PROVIDED GOODS OR SERVICES TO THE ORGANIZATION IN THE LAST SIX MONTHS. THE ORGANIZATION ALSO REQUIRES ALL DIRECTORS TO ANNUALLY SIGN A STATEMENT AFFIRMING (A) RECEIPT OF THE ORGANIZATION CONFLICT OF INTEREST POLICY (B) UNDERSTANDING OF THE POLICY AND (C) AGREEMENT WITH THE POLICY. THE ORGANIZATION CONFLICT OF INTEREST POLICY DESCRIBES HOW THE ORGANIZATION WILL RESOLVE POSSIBLE CONFLICTS OF INTEREST.

FORM 990, PART VI, SECTION B, LINE 15

THE BOARD REVIEWED AJS MEDICAL DIRECTOR'S COMPENSATION IN 2016. THE BOARD REVIEWED DATA OF COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED NONPROFIT EXECUTIVES. THE OCCURRENCE OF THESE DELIBERATIONS ARE NOTED IN THE BOARD MINUTES.

FORM 990, PART VI, SECTION C, LINE 19

SOME OR ALL OF THESE ITEMS MAYBE AVAILABLE UPON REQUEST.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2017

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