THE WALLACE MEDICAL CONCERN: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- THE WALLACE MEDICAL CONCERN (EIN 93-0853709)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-03-07
- IRS object ID
- 202440679349301909
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-03-07T19:34:39-06:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930743240 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOFFMAN STEWART & SCHMIDT PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 CENTERPOINTE DRIVE SUITE 300 | AddressLine1Txt |
| City | LAKE OSWEGO | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 970358663 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930853709 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE WALLACE MEDICAL CONCERN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WALL | BusinessNameControlTxt |
| Phone | 5034891760 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18633 SE STARK STREET 401 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97233 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LISA CLINE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5034891760 | PhoneNum |
| Signature | 2024-02-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | LISA | PersonFirstNm |
| Person Last | CLINE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JENNIFER A PERRIER | PreparerPersonNm |
| PTIN | P01321794 | PTIN |
| Phone | 5032205900 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LISA CLINE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18633 SE STARK STREET 401 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97233 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,717,753 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MYWALLACE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HEALTH SERVICES TO THOSE IN NEED IN THE PORTLAND AND GRESHAM METROPOLITAN AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 100 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,078,027 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,089,290 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,523,786 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,300,224 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,528 | PYInvestmentIncomeAmt |
| CY Investment Income | $21,914 | CYInvestmentIncomeAmt |
| PY Other Revenue | $185,108 | PYOtherRevenueAmt |
| CY Other Revenue | $306,325 | CYOtherRevenueAmt |
| PY Total Revenue | $9,791,449 | PYTotalRevenueAmt |
| CY Total Revenue | $12,717,753 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,793 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $39,558 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,250,589 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,276,071 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $335,336 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,697,928 | PYOtherExpensesAmt |
| CY Other Expenses | $3,901,771 | CYOtherExpensesAmt |
| PY Total Expenses | $9,955,310 | PYTotalExpensesAmt |
| CY Total Expenses | $11,217,400 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$163,861 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,500,353 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,319,360 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,433,244 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,213,568 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,759,977 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,105,792 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,673,267 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE WALLACE MEDICAL CONCERN ("WMC") PROVIDES AN OPEN DOOR TO EXCEPTIONAL SERVICES THAT SUPPORT INDIVIDUALS AND THEIR FAMILIES IN HEALTHY LIVING. WMC SERVES INDIVIDUALS AND FAMILIES WHO FACE BARRIERS TO CARE THROUGHOUT THE PORTLAND AND GRESHAM METROPOLITAN AREA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,199,381 | ExpenseAmt |
| Grant | $39,558 | GrantAmt |
| Revenue | $8,606,549 | RevenueAmt |
| Desc | THE WALLACE MEDICAL CONCERN (WALLACE) PROVIDES AN OPEN DOOR TO EXCEPTIONAL HEALTH SERVICES AND CONNECTIONS THAT SUPPORT INDIVIDUALS AND THEIR FAMILIES IN HEALTHY LIVING. WALLACE HAS A 35 YEAR RECORD OF PROVIDING MEDICAL SERVICES AND HAS DISTINGUISHED ITSELF AS A PATIENT CENTERED,INNOVATIVE HEALTH CARE ORGANIZATION. WALLACE BECAME A FEDERALLY QUALIFIED HEALTH CENTER IN JUNE OF 2012, ALLOWING FOR EXPANDED SERVICES AND IMPLEMENTATION OF PRIMARY CARE THAT OFFERS A COMPREHENSIVE MEDICAL HOME AND CONTINUITY OF CARE FOR PATIENTS AND THEIR FAMILIES. WE OFFER INTEGRATED MEDICAL, DENTAL, AND BEHAVIORAL/ MENTAL HEALTH SERVICES. MEDICAL SERVICES INCLUDE PEDIATRIC CARE, WOMEN'S HEALTH, AND CHRONIC DISEASE MANAGEMENT. OUR CARE TEAMS ADDRESS SOCIAL DETERMINANTS OF HEALTH SUCH AS FOOD SECURITY AND HOUSING.WALLACE'S INCREASING CAPACITY TO PROVIDE HIGH QUALITY HEALTH SERVICES IS DUE TO ITS SUCCESS IN ATTRACTING SKILLED AND COMMITTED MEDICAL PROFESSIONALS, ITS INNOVATIVE PARTNERSHIPS, AND ITS MULTICULTURAL, MULTILINGUAL STAFF. | Desc |
| Total Program Service Expenses | $8,199,381 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 100 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BILL MITBERG | PersonNm |
| Phone | 5034891760 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18633 SE STARK STREET SUITE 400 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97233 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| LYNN KETCH | ||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EDITH ARRIAGA-FLORES | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN ENGLE | ||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JAKE OHMAN | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EMANUEL BARERRA | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID MITCHELL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| VALERIE HOLMES | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MOLLY ROBERTS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANDREW BROWN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK HESS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STUART CURRIE MD | ||||||||
| CMO | 40.00 | Yes (X) | $325,495 | $0 | $27,000 | |||
| LISA CLINE | ||||||||
| CEO | 40.00 | Yes (X) | $208,389 | $0 | $6,000 | |||
| TYLER DARDIS | ||||||||
| CONTRACT CFO | 1.00 | Yes (X) | $84,670 | $0 | $0 | |||
| KYLE GEELAN DMD | ||||||||
| DENTAL DIRECTOR | 40.00 | $196,368 | $0 | $6,272 | Yes (X) | |||
| BRITTA MARTINEZ | ||||||||
| ASSISTANT DENTAL DIRECTOR | 40.00 | $167,434 | $0 | $10,053 | Yes (X) | |||
| BETHANY STAIRS | ||||||||
| ASSISTANT MEDICAL DIRECTOR | 40.00 | $137,748 | $0 | $7,982 | Yes (X) | |||
| MARY CAITLYN WELLS | ||||||||
| FAMILY NP | 40.00 | $130,699 | $0 | $8,403 | Yes (X) | |||
| KATHY TRINH | ||||||||
| FAMILY NP | 40.00 | $143,567 | $0 | $6,824 | Yes (X) | |||
| APRIL URQUIDEZ | ||||||||
| MENTAL HEALTH NP | 40.00 | $153,293 | $0 | $15,277 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,547,663 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $87,811 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CENTRAL BETHANY DEVELOPMENT CO LP | |||||
| 15160 NW LAIDLAW RD SUITE 108 | PORTLAND | OR | 97229 | RENT FOR ROCKWOOD RISING AND CONSTRUCTIO | $741,396 |
| OCHIN | |||||
| PO BOX 5426 | PORTLAND | OR | 97228 | IT AND PATIENT BILLING SERVICES | $293,371 |
| CHOICEHEALTH FINANCE | |||||
| PO BOX 790448 | ST LOUIS | MO | 631790448 | EQUIPMENT LOAN PAYMENTS | $229,278 |
| CONVERGENCE NETWORKS | |||||
| 4252 SE INTERNATIONAL WAY SUITE A | PORTLAND | OR | 97222 | IT SERVICES | $227,843 |
| HR ANNIE CONSULTING | |||||
| PO BOX 987 | CLACKAMAS | OR | 97015 | HR SERVICES | $162,419 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,096,796 | GovernmentGrantsAmt |
| All Other Contributions | $992,494 | AllOtherContributionsAmt |
| Total Contributions | $4,089,290 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| WRAP AROUND AND PREMIUM INCOME | 621110 | $4,135,509 | $4,135,509 |
| PATIENT SERVICE FEES | 621110 | $2,046,415 | $2,046,415 |
| CCO INCENTIVE | 621110 | $1,972,067 | $1,972,067 |
| PHARMACY REVENUE | 621110 | $146,233 | $146,233 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,300,224 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,914 | TotalRevenueColumnAmt |
| Exclusion | $21,914 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $55,444 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $55,444 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,444 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $55,444 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $250,881 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $250,881 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $250,881 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,717,753 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,606,549 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $21,914 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,558 | TotalAmt |
| Program Services | $39,558 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $782,947 | TotalAmt |
| Program Services | $571,552 | ProgramServicesAmt |
| Management And General | $187,907 | ManagementAndGeneralAmt |
| Fundraising | $23,488 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,354,503 | TotalAmt |
| Program Services | $3,908,787 | ProgramServicesAmt |
| Management And General | $1,285,081 | ManagementAndGeneralAmt |
| Fundraising | $160,635 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,795 | TotalAmt |
| Program Services | $120,300 | ProgramServicesAmt |
| Management And General | $39,551 | ManagementAndGeneralAmt |
| Fundraising | $4,944 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $535,065 | TotalAmt |
| Program Services | $390,597 | ProgramServicesAmt |
| Management And General | $128,416 | ManagementAndGeneralAmt |
| Fundraising | $16,052 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $438,761 | TotalAmt |
| Program Services | $320,295 | ProgramServicesAmt |
| Management And General | $105,303 | ManagementAndGeneralAmt |
| Fundraising | $13,163 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,853 | TotalAmt |
| Program Services | $9,382 | ProgramServicesAmt |
| Management And General | $3,085 | ManagementAndGeneralAmt |
| Fundraising | $386 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,774 | TotalAmt |
| Program Services | $66,995 | ProgramServicesAmt |
| Management And General | $22,026 | ManagementAndGeneralAmt |
| Fundraising | $2,753 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,001,887 | TotalAmt |
| Program Services | $731,377 | ProgramServicesAmt |
| Management And General | $240,453 | ManagementAndGeneralAmt |
| Fundraising | $30,057 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,158 | TotalAmt |
| Program Services | $27,855 | ProgramServicesAmt |
| Management And General | $9,158 | ManagementAndGeneralAmt |
| Fundraising | $1,145 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,936 | TotalAmt |
| Program Services | $104,343 | ProgramServicesAmt |
| Management And General | $34,305 | ManagementAndGeneralAmt |
| Fundraising | $4,288 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $940,185 | TotalAmt |
| Program Services | $686,335 | ProgramServicesAmt |
| Management And General | $225,644 | ManagementAndGeneralAmt |
| Fundraising | $28,206 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,874 | TotalAmt |
| Program Services | $4,288 | ProgramServicesAmt |
| Management And General | $1,410 | ManagementAndGeneralAmt |
| Fundraising | $176 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,056 | TotalAmt |
| Program Services | $14,641 | ProgramServicesAmt |
| Management And General | $4,813 | ManagementAndGeneralAmt |
| Fundraising | $602 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,539 | TotalAmt |
| Program Services | $19,374 | ProgramServicesAmt |
| Management And General | $6,369 | ManagementAndGeneralAmt |
| Fundraising | $796 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $382,754 | TotalAmt |
| Program Services | $279,410 | ProgramServicesAmt |
| Management And General | $91,861 | ManagementAndGeneralAmt |
| Fundraising | $11,483 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,315 | TotalAmt |
| Program Services | $38,190 | ProgramServicesAmt |
| Management And General | $12,556 | ManagementAndGeneralAmt |
| Fundraising | $1,569 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $709,483 | $517,923 | $170,276 | $21,284 |
| MISC EXPENSES | $106,317 | $77,611 | $25,516 | $3,190 |
| JANITORIAL | $81,685 | $59,630 | $19,604 | $2,451 |
| RECRUITING, EDUCATION M | $81,470 | $59,473 | $19,553 | $2,444 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207,485 | TotalAmt |
| Program Services | $151,465 | ProgramServicesAmt |
| Management And General | $49,796 | ManagementAndGeneralAmt |
| Fundraising | $6,224 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,217,400 | TotalAmt |
| Program Services | $8,199,381 | ProgramServicesAmt |
| Management And General | $2,682,683 | ManagementAndGeneralAmt |
| Fundraising | $335,336 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,829,882 | BOYAmt |
| EOY | $2,927,985 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,871,988 | BOYAmt |
| EOY | $1,881,368 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,086 | BOYAmt |
| EOY | $254,937 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $857,726 | BOYAmt |
| EOY | $940,766 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $186,363 | BOYAmt |
| EOY | $258,665 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,806,130 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,597,021 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,503,315 | BOYAmt |
| EOY | $2,209,109 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,960,414 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,319,360 | BOYAmt |
| EOY | $12,433,244 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $534,645 | BOYAmt |
| EOY | $692,018 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $746,634 | BOYAmt |
| EOY | $38,658 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $932,289 | BOYAmt |
| EOY | $833,987 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,195,314 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,213,568 | BOYAmt |
| EOY | $5,759,977 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,105,792 | BOYAmt |
| EOY | $6,673,267 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,105,792 | BOYAmt |
| EOY | $6,673,267 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,319,360 | BOYAmt |
| EOY | $12,433,244 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,500,353 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $67,122 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,669,341 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,899,925 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,632,191 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,078,027 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,089,290 | CurrentTaxYearAmt |
| Total | $19,368,774 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,669,341 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,899,925 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,632,191 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,078,027 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,089,290 | CurrentTaxYearAmt |
| Total | $19,368,774 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $19,368,774 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,536 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,861 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,600 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,824 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $77,358 | CurrentTaxYearAmt |
| Total | $128,179 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $121,759 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $183,446 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $321,782 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $164,532 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $250,881 | CurrentTaxYearAmt |
| Total | $1,042,400 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $20,539,353 | TotalSupportAmt |
| Public Support CY170 | 0.94300 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93810 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,789,290 | OtherCostOrOtherBasisAmt |
| Depreciation | $929,023 | DepreciationAmt |
| Book Value | $1,860,267 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $963,372 | OtherCostOrOtherBasisAmt |
| Depreciation | $667,998 | DepreciationAmt |
| Book Value | $295,374 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,468 | OtherCostOrOtherBasisAmt |
| Book Value | $53,468 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,209,109 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RIGHT OF USE ASSETS | Desc |
| Book Value | $3,960,414 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,960,414 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LEASE LIABILITIES | Desc |
| Amt | $4,195,314 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,195,314 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | WMC IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND COMPARABLE STATE LAW. IN ADDITION, WMC HAS BEEN RECOGNIZED AS A PUBLIC CHARITY UNDER SECTIONS 170(B)(1)(A)(VI) AND 509(A)(1) OF THE IRC. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED WMC'S TAX POSITIONS AND CONCLUDED THAT WMC HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|
| PATIENT AND NON-MEDICAL FINANCIAL ASSISTANCE | 315 | $15,500 | $20,922 | MARKET VALUE | MEALS, TRANSPORTAION, AND OTHER LIVING NECESSITIES |
| PATIENT HOUSING ASSISTANCE | 8 | $3,136 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FINANCIAL ASSISTANCE IS RECOMMENDED AND REQUESTED BY THE WALLACE MEDICAL CONCERN EMPLOYEE ON BEHALF OF A PATIENT WHEN THE EMPLOYEE SEES A NEED. PAYMENTS ARE MADE DIRECTLY TO THIRD PARTIES TO ASSIST PATIENTS, ENSURING THAT ALL FUND ARE USED FOR THE INTENDED PURPOSE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STUART CURRIE MD | ||||||||||||||
| CMO | $325,495 | $0 | $0 | $0 | $0 | $0 | $27,000 | $0 | $0 | $0 | $352,495 | $0 | $0 | $0 |
| LISA CLINE | ||||||||||||||
| CEO | $208,389 | $0 | $0 | $0 | $0 | $0 | $6,000 | $0 | $0 | $0 | $214,389 | $0 | $0 | $0 |
| KYLE GEELAN DMD | ||||||||||||||
| DENTAL DIRECTOR | $196,368 | $0 | $0 | $0 | $0 | $0 | $6,272 | $0 | $0 | $0 | $202,640 | $0 | $0 | $0 |
| BRITTA MARTINEZ | ||||||||||||||
| ASSISTANT DENTAL DIRECTOR | $167,434 | $0 | $0 | $0 | $0 | $0 | $10,053 | $0 | $0 | $0 | $177,487 | $0 | $0 | $0 |
| APRIL URQUIDEZ | ||||||||||||||
| MENTAL HEALTH NP | $153,293 | $0 | $0 | $0 | $0 | $0 | $15,277 | $0 | $0 | $0 | $168,570 | $0 | $0 | $0 |
| KATHY TRINH | ||||||||||||||
| FAMILY NP | $143,567 | $0 | $0 | $0 | $0 | $0 | $6,824 | $0 | $0 | $0 | $150,391 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART IV, SECTION A, LINE 1: | THE OFFICERS OF THE BOARD OF DIRECTORS AND ONE ADDITIONAL DIRECTOR SERVE AS THE MEMBERS OF THE EXECUTIVE COMMITTEE. THE CEO SITS ON THE EXECUTIVE COMMITTEE AS AN ADVISOR, BUT DOES NOT HAVE A VOTE. THE EXECUTIVE COMMITTEE HAS ALL OF THE POWERS AND AUTHORITY OF THE BOARD OF DIRECTORS WHEN ACTING IN A REASONABLE MANNER DURING AN EMERGENCY AS DELEGATED BY THE BOARD, IF IT IS IMPRACTICAL TO CONVENE A MEETING OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS REVIEWED BY MANAGEMENT. A COPY OF THE FORM 990 WILL BE PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH DIRECTOR, OFFICER, AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD-DELEGATED POWERS IS REQUIRED TO SIGN AND SUBMIT A CONFLICT OF INTEREST DISCLOSURE STATEMENT FOR CONSIDERATION BY THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD-DELEGATED POWERS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, THIS INTERESTED PERSON IS REQUIRED TO LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POTENTIAL CONFLICT. IN ADDITION, A PERIODIC REVIEW IS PERFORMED BY THE GOVERNING BOARD AND, AT A MINIMUM, INCLUDES WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE SALARY OF THE CHIEF EXECUTIVE OFFICER IS DETERMINED BY THE BOARD OF DIRECTORS AFTER A REVIEW OF THE NON-PROFIT AND HEALTH CENTER SALARY SURVEY FOR THE REGION. THIS PROCESS WAS LAST COMPLETED IN 2021. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINES 2A THROUGH 3B | THE AUDIT OF THE FINANCIAL STATEMENTS HAS NOT BEEN COMPLETED AS OF THE TIME OF FILING DUE TO STAFF CHANGES AND CHANGES IN AUDITOR. THE ORGANIZATION ANTICIPATES COMPLETING AN AUDIT ON THE SEPERATE BASIS, WHICH WILL ALSO INCLUDE AN AUDIT UNDER UNIFORM GUIDANCE (FORMERLY CALLED THE A-133 AUDIT). |