2021-02-09T13:16:57-06:00 2020-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 WEST 22ND STREET SUITE 1100 OAK BROOK IL 60523 990 2019-07-01 363828320 PCC COMMUNITY WELLNESS CENTER PCCC 7083830113 14 WEST LAKE STREET OAK PARK IL 60302 ROBERT J URSO PRESIDENT & CEO 7083830113 2021-02-02 1 CHRIS MANDERFIELD P01238973 6305738600 2021-02-01 2019 2022-09-23 18:48:47Z ROBERT J URSO 14 WEST LAKE STREET OAK PARK IL 60302 44383620 0 X WWW.PCCWELLNESS.ORG X 1992 IL PROMOTE HEALTHCARE SERVICE PROGRAMS FOR MEDICALLY UNDERSERVED LIVING IN CHICAGO COMMUNITIES 12 12 487 12 0 0 9192025 10676737 32111240 33457398 160854 114637 190821 134848 41654940 44383620 0 0 0 0 25336272 29381459 0 0 26525 12513980 13726775 37850252 43108234 3804688 1275386 31361317 37124002 9473419 13960718 21887898 23163284 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 37518105 33592246 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. 37518105 1 1 0 1 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 1 0 0 1 76 0 1 487 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 WEST 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 BARBARA VANEK DIRECTOR 2.00 X 0 0 0 WRENETHA JULION DIRECTOR 2.00 X 0 0 0 ROBERT J URSO PRESIDENT & CEO 40.00 2.00 X 340013 0 8344 PATRICK R GARRICK CHIEF FINANCIAL OFFICER 40.00 2.00 X 140406 0 6378 PAUL S LUNING MD CHIEF MEDICAL OFFICER 40.00 X 247603 0 21577 TONI BUSH REGIONAL DIRECTOR OF CLINI 40.00 X 103519 0 11597 SARA HOGUE CHIEF PERFORMANCE IMPROVEMENT OFFICER 40.00 X 83580 0 0 AMANDA BROOKS CHIEF POPULATION HEALTH OFFICER 40.00 X 126587 0 0 YAM-SHUN TONG OB/GYN PHYSICIAN 40.00 X 307822 0 9552 BERTHA LOPEZ OB/GYN PHYSICIAN 40.00 X 260203 0 23546 KAROLE A LAKOTA-TREESE MD MEDICAL DIRECTOR OF PI 40.00 X 276876 0 17998 CHRISTINE SWARTZ MEDICAL DIRECTOR 40.00 X 334616 0 1565 SHERIF MILIK FAMILY PRACTICE PHYSICIAN 40.00 X 343736 0 17998 2564961 0 118555 10 0 1 0 ATHENAHEALTH INC 311 ARSENAL STREET WATERTOWN MA 02472 MEDICAL BILLING SERVICES 1228705 US SECURITY ASSOCIATES INC 200 MANSELL COURT 5TH FLOOR ROSWELL GA 30076 SECURITY GUARD SERVICES 276248 STAFF CARE INC 12400 HIGH BLUFF DRIVE SAN DIEGO CA 92130 STAFFING SERVICE 222468 DABROWSKI MAINTENANCE SERVICE 7015 W 72ND STREET STICKNEY IL 60638 MAINTENANCE SERVICES 210043 B AND B MAINTENANCE INC 537 CAPITAL DRIVE LAKE ZURICH IL 60047 PROFESSIONAL BUILDING SERVICES 181485 5 510000 9201769 964968 10676737 NET PATIENT SERVICE FEES 621400 23445244 23445244 340B 621400 8434676 8434676 BONUSES & INCENTIVES 621400 1577478 1577478 33457398 114637 114637 MISC INCOME 900099 134848 134848 134848 44383620 33592246 0 114637 699865 72305 627560 25004591 22791557 2213034 1904347 1693898 210449 1772656 1576760 195896 81668 56949 24719 9289 6477 2812 3927523 2720270 1180728 26525 763618 632666 130952 201758 140691 61067 354513 323720 30793 131738 104926 26812 283317 206575 76742 1142195 891202 250993 240057 2763 237294 MEDICAL SUPPLIES 4124570 4109925 14645 DUES AND LICENSES 2090034 2011254 78780 REPAIRS AND MAINTENANCE 260427 157139 103288 STAFF EXPENSES 72769 2915 69854 43299 16113 27186 43108234 37518105 5563604 26525 9846114 15774317 2250934 2195239 548117 329603 1268038 526581 502153 500421 26136616 11322597 15585124 14814019 7500 7500 1353337 2976322 31361317 37124002 2784007 3278095 69985 319167 6619427 10363456 9473419 13960718 X 21887898 23163284 21887898 23163284 31361317 37124002 1275386 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 0 0 0 PART II-B, LINE 1: NACHC CONFERENCE(ADVOCACY COMMITTEE) - EMPLOYEE TRAVEL AND TIME: $2,098 519000 519000 519000 519000 14934385 3710844 11223541 4269490 2177894 2091596 4708787 3950402 758385 1704954 1483457 221497 14814019 COMMERCIAL CAPITATION RECEIVABLE 1007166 OTHER RECEIVABLES 991611 PROFESSIONAL SERVICE RECEIVABLE 977545 2976322 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 320013 0 20000 0 0 0 0 0 8344 0 348357 0 0 0 PAUL S LUNING MD CHIEF MEDICAL OFFICER 222253 0 25350 0 0 0 0 0 21577 0 269180 0 0 0 YAM-SHUN TONG OB/GYN PHYSICIAN 307222 0 600 0 0 0 0 0 9552 0 317374 0 0 0 BERTHA LOPEZ OB/GYN PHYSICIAN 259403 0 800 0 0 0 0 0 23546 0 283749 0 0 0 KAROLE A LAKOTA-TREESE MD MEDICAL DIRECTOR OF PI 237640 0 39236 0 0 0 0 0 17998 0 294874 0 0 0 CHRISTINE SWARTZ MEDICAL DIRECTOR 285826 0 48790 0 0 0 0 0 1565 0 336181 0 0 0 SHERIF MILIK FAMILY PRACTICE PHYSICIAN 341935 0 1801 0 0 0 0 0 17998 0 361734 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 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 0 0 PCC FOUNDATION C 510000 FAIR MARKET VALUE 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.