2022-02-08T15:40:23-06:00 2021-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 WEST 22ND STREET SUITE 1100 OAK BROOK IL 60523 990 2020-07-01 363828320 PCC COMMUNITY WELLNESS CENTER PCCC 7083830113 14 LAKE STREET OAK PARK IL 60302 TONI BUSH PRESIDENT & CEO 7083830113 2022-02-01 1 TONI BUSH 999009999 CHRIS MANDERFIELD P01238973 6305738600 2022-02-01 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z TONI BUSH 14 LAKE STREET OAK PARK IL 60302 48912367 0 X WWW.PCCWELLNESS.ORG X 1992 IL PROMOTE HEALTHCARE SERVICE PROGRAMS FOR MEDICALLY UNDERSERVED LIVING IN CHICAGO COMMUNITIES 12 12 506 12 0 0 10676737 15365261 33457398 33126019 114637 55258 134848 365829 44383620 48912367 0 0 0 0 29381459 31533196 0 0 0 13726775 14428999 43108234 45962195 1275386 2950172 37124002 34639453 13960718 10910636 23163284 23728817 X THE MISSION OF PCC COMMUNITY WELLNESS CENTER IS TO IMPROVE HEALTH OUTCOMES FOR THE MEDICALLY UNDERSERVED COMMUNITY THROUGH THE PROVISION OF HIGH QUALITY, AFFORDABLE, AND ACCESSIBLE PRIMARY HEALTH CARE AND SUPPORT SERVICES. ANCHORED WITH FAMILY MEDICINE, WE ARE COMMITTED TO SERVING THE NEEDS OF ALL PEOPLE IN ALL STAGES OF LIFE. 0 0 39482162 33491848 PCC PROVIDES HEALTH CARE SERVICES TO THE COMMUNITY. PCC HEALTH CARE SERVICES INCLUDE: PEDIATRIC AND ADOLESCENT HEALTH CARE THAT INCLUDES WELL-CHILD EXAMS, IMMUNIZATIONS, SICK INFANT/CHILD EXAMS, SCHOOL AND SPORTS PHYSICALS, AND LEAD SCREENINGS; WOMEN'S HEALTH CARE (OB/GYN) THAT INCLUDES MATERNITY CARE AND DELIVERY, PAP SMEARS, AND BREAST CANCER SCREENINGS; ADULT HEALTH CARE; SENIOR HEALTH CARE; DIAGNOSIS AND TREATMENT OF ILLNESS; DISEASE SCREENING AND PREVENTION; FAMILY PLANNING (BIRTH CONTROL); MANAGEMENT OF CHRONIC ILLNESSES SUCH AS ASTHMA, DIABETES, AND HIGH BLOOD PRESSURE; HIV TESTING, COUNSELING, AND PRIMARY CARE; AND DENTAL CARE AND REFERRAL. 39482162 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 62 0 506 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X PATRICK GARRICK 7083830113 14 LAKE STREET OAK PARK IL 60302 RON AUSTIN DIRECTOR 2.00 2.00 X 0 0 0 KENNETH BLAIR MD TREASURER 2.00 2.00 X X 0 0 0 VELDA BRUNNER DIRECTOR 2.00 X 0 0 0 BARBARA DIGGINS DIRECTOR 2.00 X 0 0 0 CAROLYN FITZPATRICK MD CHAIRPERSON 2.00 X X 0 0 0 PATRICIA FORD DIRECTOR 2.00 X 0 0 0 MELINDA MALECKI SECRETARY 2.00 X X 0 0 0 JOHN MCDONNELL DIRECTOR 2.00 2.00 X 0 0 0 MARIANA OSORIA DIRECTOR 2.00 X 0 0 0 TERESA REYES VICE CHAIRPERSON 2.00 X X 0 0 0 WRENETHA JULION DIRECTOR 2.00 X 0 0 0 JULIETTE STANCIL DIRECTOR 2.00 X 0 0 0 ROBERT J URSO PRESIDENT & CEO 40.00 2.00 X 354659 0 8550 PATRICK R GARRICK CHIEF FINANCIAL OFFICER 40.00 2.00 X 104218 0 0 PAUL S LUNING MD CHIEF MEDICAL OFFICER 40.00 X 222413 0 22047 TONI BUSH CHIEF OPERATING OFFICER 40.00 X 132440 0 0 SARA HOGUE CHIEF PERFORMANCE IMPROVEM 40.00 X 130282 0 0 AMANDA BROOKS CHIEF POPULATION HEALTH OF 40.00 X 99688 0 0 BERTHA LOPEZ OB/GYN PHYSICIAN 40.00 X 235599 0 24125 KAROLE A LAKOTA-TREESE MD MEDICAL DIRECTOR OF PI 40.00 X 273720 0 18330 CHRISTINE SWARTZ MEDICAL DIRECTOR 40.00 X 358507 0 0 SHERIF MILIK FAMILY PRACTICE PHYSICIAN 40.00 X 333965 0 18330 KATHLEEN MCDONOUGH MEDICAL DIRECTOR 40.00 X 205913 0 18330 2451404 0 109712 33 0 1 0 ATHENAHEALTH INC 311 ARSENAL STREET WATERTOWN MA 02472 MEDICAL BILLING SERVICES 1035579 MONTERRY SECURITY 2232 S BLUE ISLAND AVENUE CHICAGO IL 60608 SECURITY GUARD SERVICES 559876 B AND B MAINTENANCE INC 537 CAPITAL DRIVE LAKE ZURICH IL 60047 PROFESSIONAL BUILDING SERVICES 271638 DABROWSKI MAINTENANCE SERVICE 7015 W 72ND STREET STICKNEY IL 60638 MAINTENANCE SERVICES 254736 CANARY HR CONSULTING 20650 S CICERO MATTESON IL 60443 HR CONSULTING 202250 7 35000 13635978 1694283 15365261 PATIENT SERVICE FEES 621400 25104768 25104768 340B 621400 6843842 6843842 BONUSES & INCENTIVES 621400 794909 794909 MEANINGFUL USE 621400 382500 382500 33126019 55258 55258 MISC INCOME 900099 365829 365829 365829 48912367 33491848 0 55258 X 1043700 294913 748787 26479381 24305172 2174209 2044696 1827539 217157 1965419 1756682 208737 113275 72366 40909 61200 39098 22102 4750399 3034802 1715597 806756 679755 127001 173776 111017 62759 597550 537166 60384 186154 152434 33720 178363 96469 81894 1149180 811463 337717 297196 2660 294536 MEDICAL SUPPLIES 3935350 3918214 17136 DUES AND LICENSES 1780604 1711191 69413 STAFF EXPENSES 186088 43 186045 REPAIRS AND MAINTENANCE 99740 93625 6115 113368 37553 75815 45962195 39482162 6480033 0 15774317 12175346 2195239 2138345 329603 308590 526581 893609 500421 778959 27654205 12471776 14814019 15182429 7500 7500 2976322 3154675 37124002 34639453 3278095 4047071 319167 315661 10363456 6547904 13960718 10910636 X 23163284 23728817 23163284 23728817 37124002 34639453 X 2950172 -642139 -1742500 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 754034 754034 14968733 4147023 10821710 4459876 2327340 2132536 5507144 4374178 1132966 1964418 1623235 341183 15182429 COMMERCIAL CAPITATION RECEIVABLE 1229873 OTHER RECEIVABLES 1310552 PROFESSIONAL SERVICE RECEIVABLE 614250 3154675 X PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND RELATED STATE OF ILLINOIS STATUTES; THEREFORE THE ORGANIZATION HAS MADE NO PROVISION FOR FEDERAL INCOME TAXES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION ADOPTED THE REQUIREMENTS IN FINANCIAL ACCOUNTING STANDARDS BOARD(FASB) ACCOUNTING STANDARDS UPDATE (ASU) 2009-06 REGARDING UNCERTAIN TAX POSITIONS. ASU 2009-06 DEFINES HOW UNCERTAIN TAX POSITIONS SHOULD BE RECOGNIZED, MEASURED, PRESENTED, AND DISCLOSED IN THE FINANCIAL STATEMENTS. THE AUTHORITATIVE GUIDANCE REQUIRES ENTITIES TO RECOGNIZE A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE POSITION IS SUSTAINABLE BASED SOLELY ON ITS TECHNICAL MERITS AND CONSIDERATION OF THE RELEVANT TAXING AUTHORITY'S WIDELY UNDERSTOOD ADMINISTRATIVE PRACTICES AND PRECEDENTS. THE ORGANIZATION EVALUATED ITS TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN TO DETERMINE WHETHER THE TAX POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED BY THE APPLICABLE TAXING AUTHORITY, AND HAS DETERMINED THAT IT CURRENTLY DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS. 1 X X X X 0 0 0 0 0 0 0 0 0 ROBERT J URSO PRESIDENT & CEO 334659 0 20000 0 0 0 0 0 8550 0 363209 0 0 0 CHRISTINE SWARTZ MEDICAL DIRECTOR 339982 0 18525 0 0 0 0 0 0 0 358507 0 0 0 SHERIF MILIK FAMILY PRACTICE PHYSICIAN 332890 0 1075 0 0 0 0 0 18330 0 352295 0 0 0 KAROLE A LAKOTA-TREESE MD MEDICAL DIRECTOR OF PI 219777 0 53943 0 0 0 0 0 18330 0 292050 0 0 0 BERTHA LOPEZ OB/GYN PHYSICIAN 234799 0 800 0 0 0 0 0 24125 0 259724 0 0 0 PAUL S LUNING MD CHIEF MEDICAL OFFICER 202951 0 19462 0 0 0 0 0 22047 0 244460 0 0 0 KATHLEEN MCDONOUGH MEDICAL DIRECTOR 198851 0 7062 0 0 0 0 0 18330 0 224243 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THERE IS AN INTERNAL REVIEW PROCESS WHICH IS PERFORMED BY THE CHIEF FINANCIAL OFFICER AND CHIEF EXECUTIVE OFFICER. SUBSEQUENT TO THAT REVIEW, THE 990 IS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS WHO THEN SUBMITS THE RETURN TO THE ENTIRE BOARD FOR APPROVAL. A COPY OF THE RETURN IS KEPT ON RECORD FOR PUBLIC REVIEW SHOULD THERE BE SUCH A REQUEST. FORM 990, PART VI, SECTION B, LINE 12C ALL TRANSACTIONS AND PROCESSES ARE REVIEWED AND MONITORED THROUGH POLICY, EXECUTIVE MANAGEMENT, AND RATIFIED BY THE VOTING MEMBERS OF THE BOARD, IF NECESSARY. ALL STAFF AND BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT WHICH IS KEPT IN EACH STAFF AND BOARD MEMBERS' FILES. DISCLOSURE OF CONFLICT OF INTEREST POLICY QUESTION IS PRESENTED TO EVERY STAFF OR BOARD MEMBER DURING THE RECRUITING OR HIRING PROCESS. FURTHERMORE, AT ANY JUNCTURE WHEN MAJOR DECISIONS ARE ABOUT TO BE MADE, INDIVIDUALS RAE ASKED TO DISCLOSE ANY CONFLICTS THAT MAY EXIST. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS OF DETERMINING COMPENSATION FOR THE CEO AND OTHER KEY OFFICERS OF THE ORGANIZATION IS DONE THROUGH A REVIEW AND APPROVAL PROCESS VIA THE GOVERNING BODY, AND SUBJECT TO RATIFICATION OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,535,550. MANAGEMENT AND GENERAL EXPENSES 868,056. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,403,606. SECURITY: PROGRAM SERVICE EXPENSES 434,249. MANAGEMENT AND GENERAL EXPENSES 245,485. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 679,734. JANITORIAL: PROGRAM SERVICE EXPENSES 229,637. MANAGEMENT AND GENERAL EXPENSES 129,816. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 359,453. MEDICAL DIRECTOR: PROGRAM SERVICE EXPENSES 140,393. MANAGEMENT AND GENERAL EXPENSES 79,366. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 219,759. BILLING: PROGRAM SERVICE EXPENSES 694,973. MANAGEMENT AND GENERAL EXPENSES 392,874. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,087,847. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS TO PCC FOUNDATION -5,500,000. GAIN ON FORGIVENESS OF DEBT 3,757,500. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PCC FOUNDATION 14 LAKE STREET OAK PARK IL 60302 475608703 SEE PART VII IL 501(C)(3) LINE 12A, I PCC COMMUNITY WELLNESS CENTER 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PCC FOUNDATION C 35000 CASH PCC FOUNDATION R 5500000 CASH FORM 990, SCHEDULE R, PART II, COLUMN (B) THE PCC FOUNDATION CONDUCTS FUNDRAISING ACTIVITIES FOR PCC COMMUNITY WELLNESS CENTER ("CENTER") AND INTENDS TO AWARD GRANTS TO THE CENTER UPON REQUEST.