WABASH VALLEY HEALTH CENTER: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- WABASH VALLEY HEALTH CENTER (EIN 45-3023360)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-02-07
- IRS object ID
- 202210389349300211
- Schema version
- 2020v4.2
- 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 | 2022-02-07T08:23:07-06:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351327464 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SACKRIDER & COMPANY INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1925 Wabash Ave | AddressLine1Txt |
| City | Terre Haute | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47807 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453023360 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wabash Valley Health Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WABA | BusinessNameControlTxt |
| Phone | 8122327447 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1436 Locust Street | AddressLine1Txt |
| City | Terre Haute | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47807 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mike Smith | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 8122327447 | PhoneNum |
| Signature | 2022-02-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Mike | PersonFirstNm |
| Person Last | Smith | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Eleanor M Caldwell CPA | PreparerPersonNm |
| PTIN | P00634823 | PTIN |
| Phone | 8122329492 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Same as C above | PrincipalOfficerNm |
| Gross Receipts | $5,923,110 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.wabashvalleyhealthcenter.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | To provide primary health care, dental care, behavioral health, and related services to those in need of care. including the medically underserved uninsured and vulnerable population in the Wabash Valley without regard to the patient's ability to pay. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 44 | TotalEmployeeCnt |
| Total Volunteers | 2 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,328,026 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,782,585 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,556,752 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,130,332 | CYProgramServiceRevenueAmt |
| PY Investment Income | $35,474 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,597 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $4,920,252 | PYTotalRevenueAmt |
| CY Total Revenue | $5,916,514 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,506,952 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,867,916 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $962,102 | PYOtherExpensesAmt |
| CY Other Expenses | $1,685,003 | CYOtherExpensesAmt |
| PY Total Expenses | $3,469,054 | PYTotalExpensesAmt |
| CY Total Expenses | $4,552,919 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,451,198 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,363,595 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,071,409 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,122,172 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,053,167 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $740,335 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,018,242 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,381,837 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To provide primary health care, dental care, behavioral health, and related services to those in need of care, including the medically underserved uninsured and vulnerable population in the Wabash Valley without regard to the patient's ability to pay. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,087,548 | ExpenseAmt |
| Revenue | $5,916,514 | RevenueAmt |
| Desc | STRATEGIC OBJECTIVE 1: FINANCIAL STABILITY Financial position remains strong; finished FY at 189 days cash on hand Achieved a 15.8% increase in patient encounters versus FY 2020 Provided services for 5,494 unduplicated patients (CY 2020) Completion of expansion and renovation project STRATEGIC OBJECTIVE 2: HUMAN RESOURCE ENGAGEMENT Maintained staffing throughout COVID-19 pandemic; no reduction in force Exceptional level of student satisfaction Successful recruitment and retention, including new MD, new NP, and new dentistSTRATEGIC OBJECTIVE 3: SUPERIOR QUALITY & SERVICE Exceptional patient satisfaction results Received HRSA Improving Quality of Care Awards Sustained operations throughout the COVID-19 pandemic, including providing COVID vaccination and testing Awarded recognition by the National Committee for Quality Assurance Patient-Centered Medical Home Program HRSA federal survey: achieved full compliance with all program requirements | Desc |
| Total Program Service Expenses | $3,087,548 | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 | Yes (1) | 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 | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 44 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | Yes (1) | 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 | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sarah Kearns | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8122327447 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1436 Locust Street | AddressLine1Txt |
| City | Terre Haute | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47807 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Peter Ciancone | |||||||
| President | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Tina Elliott | |||||||
| Secretary | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Judge Mike Eldred | |||||||
| Member | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Gary Broyles | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Bobby Moore | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Mike Smith | |||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Julie Baesler | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Tammy Pupilli | |||||||
| member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Chris Newlin | |||||||
| Vice President | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Bob Rhodes | |||||||
| Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Isaiah Jernberg | |||||||
| Dental Med Dir | 40.00 | Yes (X) | $152,469 | $0 | $25,331 | ||
| Charles Welker | |||||||
| CEO | 40.00 | Yes (X) | $147,260 | $0 | $16,708 | ||
| Earl Elliott | |||||||
| CFO | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| Gregory Brock | |||||||
| CMO | 40.00 | Yes (X) | $208,854 | $0 | $6,473 | ||
| Sarah Kearns | |||||||
| COO | 40.00 | Yes (X) | $90,110 | $0 | $6,556 | ||
| Melinda Hendrix | |||||||
| Nurse Practitioner | 40.00 | $107,697 | $0 | $8,883 | Yes (X) | ||
| Davy Montgomery | |||||||
| Dir of Data Analytics & Re | 40.00 | $102,687 | $0 | $8,281 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $809,077 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $72,232 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,459,830 | GovernmentGrantsAmt |
| All Other Contributions | $322,755 | AllOtherContributionsAmt |
| Total Contributions | $2,782,585 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Service Revenu | Desc |
| Business | 624110 | BusinessCd |
| Total Revenue Column | $3,130,332 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,130,332 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,130,332 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,193 | TotalRevenueColumnAmt |
| Exclusion | $10,193 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $6,596 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$6,596 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$6,596 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$6,596 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,916,514 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,123,736 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,193 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,408 | TotalAmt |
| Management And General | $294,408 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,187,978 | TotalAmt |
| Program Services | $1,796,950 | ProgramServicesAmt |
| Management And General | $391,028 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,739 | TotalAmt |
| Program Services | $27,125 | ProgramServicesAmt |
| Management And General | $29,614 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,388 | TotalAmt |
| Program Services | $109,380 | ProgramServicesAmt |
| Management And General | $39,008 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,403 | TotalAmt |
| Program Services | $131,418 | ProgramServicesAmt |
| Management And General | $48,985 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,045 | TotalAmt |
| Management And General | $61,045 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,898 | TotalAmt |
| Management And General | $49,898 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,890 | TotalAmt |
| Management And General | $28,890 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,147 | TotalAmt |
| Management And General | $20,147 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,615 | TotalAmt |
| Program Services | $214,753 | ProgramServicesAmt |
| Management And General | $23,862 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,503 | TotalAmt |
| Program Services | $71,173 | ProgramServicesAmt |
| Management And General | $44,330 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,058 | TotalAmt |
| Program Services | $9,503 | ProgramServicesAmt |
| Management And General | $15,555 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,331 | TotalAmt |
| Program Services | $22,358 | ProgramServicesAmt |
| Management And General | $182,973 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,106 | TotalAmt |
| Program Services | $19,167 | ProgramServicesAmt |
| Management And General | $11,939 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Clinical Supplies | $636,055 | $541,871 | $94,184 |
| Contract Labor | $116,352 | $116,352 | |
| Supplies | $49,437 | $3,371 | $46,066 |
| Other expenses | $28,465 | $28,465 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,101 | TotalAmt |
| Program Services | $24,127 | ProgramServicesAmt |
| Management And General | $54,974 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,552,919 | TotalAmt |
| Program Services | $3,087,548 | ProgramServicesAmt |
| Management And General | $1,465,371 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,117,651 | BOYAmt |
| EOY | $2,087,212 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,358 | BOYAmt |
| EOY | $250,487 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,478 | BOYAmt |
| EOY | $192,812 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $567,924 | BOYAmt |
| EOY | $449,319 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,434 | BOYAmt |
| EOY | $16,103 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,651,524 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $527,785 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $412,750 | BOYAmt |
| EOY | $4,123,739 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,586,814 | BOYAmt |
| EOY | $2,500 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,071,409 | BOYAmt |
| EOY | $7,122,172 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $597,938 | BOYAmt |
| EOY | $229,468 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,968 | BOYAmt |
| EOY | $94,203 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $405,261 | BOYAmt |
| EOY | $416,664 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,053,167 | BOYAmt |
| EOY | $740,335 | 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 | $4,984,422 | BOYAmt |
| EOY | $6,326,003 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,820 | BOYAmt |
| EOY | $55,834 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,018,242 | BOYAmt |
| EOY | $6,381,837 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,071,409 | BOYAmt |
| EOY | $7,122,172 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,363,595 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,558,507 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,574,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,345,388 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,328,026 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,775,989 | CurrentTaxYearAmt |
| Total | $9,581,910 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,778,938 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,355,727 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,498,382 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,556,752 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,130,331 | CurrentTaxYearAmt |
| Total | $12,320,130 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,337,445 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,929,727 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,843,770 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,884,778 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,906,320 | CurrentTaxYearAmt |
| Total | $21,902,040 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $21,902,040 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $97 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,571 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,439 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $33,574 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,194 | CurrentTaxYearAmt |
| Total | $84,875 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $97 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,571 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,439 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $33,574 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,194 | CurrentTaxYearAmt |
| Total | $84,875 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,337,542 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,939,298 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,875,209 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,918,352 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,916,514 | CurrentTaxYearAmt |
| Total | $21,986,915 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99610 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99840 | PublicSupportPY509Pct |
| Investment Income CY | 0.00390 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00400 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,947 | OtherCostOrOtherBasisAmt |
| Book Value | $4,947 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,968,776 | OtherCostOrOtherBasisAmt |
| Depreciation | $266,650 | DepreciationAmt |
| Book Value | $3,702,126 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $677,801 | OtherCostOrOtherBasisAmt |
| Depreciation | $261,135 | DepreciationAmt |
| Book Value | $416,666 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,123,739 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | TH DOR Forgiveable Loan | Desc |
| Amt | $416,664 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $416,664 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $5,923,110 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $6,596 | OtherRevenueAmt |
| Revenue Not Reported | $6,596 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,916,514 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $5,916,514 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,559,515 | TotExpnsEtcAuditedFinclStmtAmt |
| Losses Reported | $6,596 | LossesReportedAmt |
| Expenses Not Reported | $6,596 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,552,919 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,552,919 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Center and recognize a tax liability if the Center has taken an uncertain tax position that more likely than not would not be sustained upon exmination by various federal and state taxing authorities. Management has analyzed the tax positions taken by the Center and has concluded that as of June 30, 2021 and 2020, there are no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the accompanying financial statements. The Center is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. |
| Part XI, Line 2d - Other Adjustments: | Loss on sale of asset 6,596. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gregory Brock | ||||||||||||||
| CMO | $204,554 | $0 | $4,300 | $0 | $0 | $0 | $6,198 | $0 | $275 | $0 | $215,327 | $0 | $0 | $0 |
| Isaiah Jernberg | ||||||||||||||
| Dental Med Dir | $148,669 | $0 | $3,800 | $0 | $0 | $0 | $2,470 | $0 | $22,861 | $0 | $177,800 | $0 | $0 | $0 |
| Charles Welker | ||||||||||||||
| CEO | $143,760 | $0 | $3,500 | $0 | $0 | $0 | $4,666 | $0 | $12,042 | $0 | $163,968 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sackrider and Company | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CPA/Accounting | RelationshipDescriptionTxt |
| Transaction | $74,874 | TransactionAmt |
| Transaction | CFO/Accounting Services | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule L Line (1) | FormAndLineReferenceDesc |
| Explanation | The Wabash Valley Health Center outsources its CFO and accounting duties to a local CPA firm, Sackrider & Company. Tina Elliott (Secretary) is married to Earl Elliott, who is a partner in Sackrider and Company. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Line 2 explanation - Tina Elliott (Secretary) and Earl Elliott (CFO) are married. |
| Form 990, Part VI, Section A, line 3 | Line 3 explanation - The Wabash Valley Health Center's accounting and CFO duties are outsourced to a local CPA firm, Sackrider & Company, through a contractual agreement. These duties are under the supervision of the Board. |
| Form 990, Part VI, Section B, line 11b | Line 11b Explanation - Copies of the Form 990 are provided to the members of the Finance Committee and the Board and are presented by the CFO at a meeting. They are asked to review, question and/or comment, and approve. |
| Form 990, Part VI, Section B, line 12c | The organization annually reviews compliance with the conflict of interest policy. |
| Form 990, Part VI, Section B, line 15a | The Organization's Executive Committee conducts a review of the CEO's performance and proposes any pay adjustments to the Board of Directors for approval. The President obtains salary comparability data of the FQHC industry which is shared with the Executive Committee and used in the process. |
| Form 990, Part VI, Section C, line 19 | Governing documents, conflict of interest policy and financial statements are available to the public upon request. |
| Change of Oversight or Selection Process | The Board of Directors assumes responsibility for oversight of the audit of the financial statements and no processes have changed from the prior year. |