THE WALLACE MEDICAL CONCERN: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- THE WALLACE MEDICAL CONCERN (EIN 93-0853709)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-04-30
- IRS object ID
- 201911209349301951
- Schema version
- 2017v2.3
- 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 | 2019-04-30T19:40:11-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10700 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | 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 | 124 NE 181ST AVENUE NO 103 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97230 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUZANNE SIMMONS | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 5034891760 | PhoneNum |
| Signature | 2019-04-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT BENNION CPA | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Preparation | 2019-04-18 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-04-18 | IPDt |
| IP Tm | 18:42:52 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D9296ABB841A0B8370F91367E66032AC87F74933 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 84BDE7AD4ADB62213C7E1A191A12ED9082B4B320 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | 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 | 124 NE 181ST AVENUE NO 103 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97230 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,023,221 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WALLACEMEDICAL.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 | 75 | TotalEmployeeCnt |
| Total Volunteers | 23 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,755,689 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,931,945 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,268,934 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,867,466 | CYProgramServiceRevenueAmt |
| PY Investment Income | $258 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,032 | CYInvestmentIncomeAmt |
| PY Other Revenue | $131,266 | PYOtherRevenueAmt |
| CY Other Revenue | $222,778 | CYOtherRevenueAmt |
| PY Total Revenue | $6,156,147 | PYTotalRevenueAmt |
| CY Total Revenue | $7,023,221 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $5,890 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,664,636 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,460,277 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $12,301 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $109,075 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,139,738 | PYOtherExpensesAmt |
| CY Other Expenses | $2,577,972 | CYOtherExpensesAmt |
| PY Total Expenses | $6,816,675 | PYTotalExpensesAmt |
| CY Total Expenses | $6,044,139 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$660,528 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $979,082 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,699,401 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,587,375 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $369,046 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $278,020 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,330,355 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,309,355 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE WALLACE MEDICAL CONCERN ("WMC") PROVIDES AN OPEN DOOR TO EXCEP- TIONAL HEALTH 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 | $4,668,382 | ExpenseAmt |
| Grant | $5,890 | GrantAmt |
| Revenue | $3,867,466 | RevenueAmt |
| Desc | THE WALLACE MEDICAL CONCERN (WMC) PROVIDES AN OPEN DOOR TO EXCEPTIONAL HEALTH SERVICES AND CONNECTIONS THAT SUPPORT INDIVIDUALS AND THEIR FAMILIES IN HEALTHY LIVING. WMC HAS DISTINGUISHED ITSELF FOR OVER THIRTY YEARS AS A PATIENT-FOCUSED, INNOVATIVE HEALTH CARE ORGANIZATION OFFERING A WIDE ARRAY OF SERVICES. SINCE RECEIVING DESIGNATION AS A FEDERALLY QUALIFIED HEALTH CENTER IN 2012, WMC HAS EXPANDED SERVICES TO INCLUDE COMPREHENSIVE PRIMARY CARE, BEHAVIORAL/MENTAL HEALTH AND ORAL HEALTH CARE. WE OFFER OUR PATIENTS AND THEIR FAMILIES A COMPREHENSIVE HEALTH HOME PROVIDING CONTINUITY OF CARE AND FULL INTEGRATION OF MEDICAL AND DENTAL SERVICES. CONTINUED ON SCHEDULE O. WMC'S INCREASING CAPACITY TO DELIVER HIGH-QUALITY, MULTI-DISCIPLINARY CARE IS THE RESULT OF ITS SUCCESS AT ATTRACTING AND RETAINING SKILLED AND COMMITTED HEALTH PROFESSIONALS, A CULTURALLY-APPROPRIATE APPROACH, INNOVATIVE PARTNERSHIPS, AND ONGOING COMMUNITY INVESTMENT. OUR PROGRAMS ADDRESS SOCIAL DETERMINANTS OF HEALTH SUCH AS NUTRITION/FOOD ACCESS AND ORAL HEALTH, WHICH PLAY A PIVOTAL ROLE IN CHILDREN'S DEVELOPMENT. OUR COMPREHENSIVE PRIMARY CARE SERVICES INCLUDE WELL CHILD, WOMEN'S HEALTH, BEHAVIORAL HEALTH AND CHRONIC DISEASE MANAGEMENT. WE OFFER SPECIALTY CLINICS IN DERMATOLOGY, PODIATRY, OPTOMETRY, CHIROPRACTIC AND DENTAL. WE ALSO PLAY A CRITICAL ROLE AS A GATEWAY TO THE LARGER HEALTH CARE SYSTEM, SECURING REFERRALS FOR NO-COST SPECIALTY AND HOSPITAL CARE. WITH BILINGUAL STAFF, PROFESSIONAL INTERPRETER VOLUNTEERS, AND AN EMPHASIS ON HEALTH LITERACY, HEALTH EDUCATION AND PREVENTION, WMC IS ABLE TO PROVIDE CULTURALLY APPROPRIATE CARE TO NON-ENGLISH SPEAKING PATIENTS. THE HEALTH ACCESS WINDOW AT THE MEXICAN CONSULATE OFFERS HEALTH PROMOTION AND DISEASE PREVENTION ASSISTANCE. THE MOBILE MEDICAL CLINIC AND THE NEW ROCKWOOD CLINIC LOCATED OFF THE MAX LINE OFFER ACCESSIBILITY TO THOSE WITH LIMITED TRANSPORTATION OPTIONS.WMC PROVIDES AN OPEN DOOR TO EXCEPTIONAL HEALTH SERVICES AND CONNECTIONS THAT SUPPORT INDIVIDUALS AND THEIR FAMILIES IN HEALTHY LIVING. WMC HAS A 34-YEAR RECORD OF PROVIDING MEDICAL SERVICES AND HAS DISTINGUISHED ITSELF AS A PATIENT-FOCUSED, INNOVATIVE HEALTH CARE ORGANIZATION. WMC BECAME A FEDERALLY QUALIFIED HEALTH CENTER IN JUNE OF 2012, ALLOWING FOR EXPANSION OF SERVICES AND IMPLEMENTATION OF PRIMARY CARE THAT OFFERS A COMPREHENSIVE MEDICAL HOME AND CONTINUITY OF CARE FOR PATIENTS AND THEIR FAMILIES. WMC'S INCREASING CAPACITY TO PROVIDE HIGH QUALITY HEALTH SERVICES IS THE RESULT OF ITS SUCCESS AT ATTRACTING AND MAINTAINING SKILLED AND COMMITTED MEDICAL PROFESSIONALS, ITS INNOVATIVE PARTNERSHIPS, AND THE HIRING OF BILINGUAL, BICULTURAL CARE PROVIDERS AND CLINIC STAFF. | Desc |
| Total Program Service Expenses | $4,668,382 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 0 | 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 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 22 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 75 | 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 |
| 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 | 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 | 0 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARRIE HARRIS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5037666038 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 124 NE 181ST AVENUE NO 103 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97230 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 |
|---|---|---|---|---|---|---|---|
| LISA GOREN | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LYNN KETCH | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARILYNN WEBER | |||||||
| TREASURER (THROUGH OCT 2017) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SUZANNE SIMMONS | |||||||
| DIRECTOR & TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PATRICIA HICKS | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ADELE ATWOOD | |||||||
| DIRECTOR (THROUGH JULY 2017) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EMMANUEL BARRERA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| VIRGINIA CORNYN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN ENGLE DDS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CARLOS GALEANA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SHAY MCCAW | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TAMRA ORR | |||||||
| DIRECTOR (THROUGH OCT 2017) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MAUREEN WRIGHT MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LISA CLINE | |||||||
| CEO | 40.00 | Yes (X) | $141,758 | $0 | $7,422 | ||
| AMY BRISSON | |||||||
| CFO (THROUGH JAN 2018) | 40.00 | Yes (X) | $73,074 | $0 | $8,935 | ||
| CARRIE HARRIS | |||||||
| CFO | 40.00 | Yes (X) | $2,083 | $0 | $0 | ||
| STUART CURRIE MD | |||||||
| CMO | 40.00 | Yes (X) | $270,516 | $0 | $8,147 | ||
| KYLE GEELAN DMD | |||||||
| DENTAL DIRECTOR | 40.00 | $136,216 | $0 | $8,895 | Yes (X) | ||
| JULIA FREY PA | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $113,150 | $0 | $9,889 | Yes (X) | ||
| BETHANY STAIRS FNP | |||||||
| NURSE PRACTITIONER | 40.00 | $108,243 | $0 | $9,499 | Yes (X) | ||
| AZAD JOHN-SALIMI MD | |||||||
| PHYSICIAN | 40.00 | $107,439 | $0 | $7,632 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $952,479 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $60,419 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LIFEWORKS NW | |||||
| 14600 NW CORNELL ROAD | PORTLAND | OR | 97229 | HEALTHCARE STAFFING | $157,146 |
| LINGUAVA INTERPRETERS | |||||
| 12106 NE MARX STREET | PORTLAND | OR | 97220 | INTERPRETATION SERVICES | $120,097 |
| OCHIN | |||||
| 1881 SW NAITO PARKWAY | PORTLAND | OR | 97201 | I.T. SERVICES | $117,435 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,563,765 | GovernmentGrantsAmt |
| All Other Contributions | $368,180 | AllOtherContributionsAmt |
| Total Contributions | $2,931,945 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT BILLING | 621110 | $3,563,675 | $3,563,675 |
| CCO INCENTIVE | 621110 | $303,791 | $303,791 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,867,466 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $605 | TotalRevenueColumnAmt |
| Exclusion | $605 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $427 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $427 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $427 | TotalRevenueColumnAmt |
| Exclusion | $427 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| INSURANCE REIMBURSEMEN | 900099 | $138,278 | $138,278 |
| MEANINGFUL USE REVENUE | 900099 | $42,500 | $42,500 |
| OTHER INCOME | 900099 | $42,000 | $42,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $222,778 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,023,221 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,867,466 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $223,810 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,890 | TotalAmt |
| Program Services | $5,890 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $558,857 | TotalAmt |
| Management And General | $558,857 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,357,355 | TotalAmt |
| Program Services | $2,113,638 | ProgramServicesAmt |
| Management And General | $168,760 | ManagementAndGeneralAmt |
| Fundraising | $74,957 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,560 | TotalAmt |
| Program Services | $59,966 | ProgramServicesAmt |
| Management And General | $4,454 | ManagementAndGeneralAmt |
| Fundraising | $2,140 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $233,522 | TotalAmt |
| Program Services | $183,536 | ProgramServicesAmt |
| Management And General | $44,071 | ManagementAndGeneralAmt |
| Fundraising | $5,915 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,983 | TotalAmt |
| Program Services | $178,282 | ProgramServicesAmt |
| Management And General | $58,961 | ManagementAndGeneralAmt |
| Fundraising | $6,740 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,602 | TotalAmt |
| Management And General | $19,602 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,615 | TotalAmt |
| Program Services | $637 | ProgramServicesAmt |
| Management And General | $2,978 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,090 | TotalAmt |
| Management And General | $115,090 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $567,537 | TotalAmt |
| Program Services | $536,695 | ProgramServicesAmt |
| Management And General | $18,799 | ManagementAndGeneralAmt |
| Fundraising | $12,043 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,316 | TotalAmt |
| Program Services | $2,198 | ProgramServicesAmt |
| Management And General | $16,519 | ManagementAndGeneralAmt |
| Fundraising | $2,599 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,858 | TotalAmt |
| Program Services | $29,199 | ProgramServicesAmt |
| Management And General | $11,206 | ManagementAndGeneralAmt |
| Fundraising | $1,453 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,580 | TotalAmt |
| Program Services | $34,110 | ProgramServicesAmt |
| Management And General | $13,470 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $332,551 | TotalAmt |
| Program Services | $235,211 | ProgramServicesAmt |
| Management And General | $97,340 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,997 | TotalAmt |
| Program Services | $3,424 | ProgramServicesAmt |
| Management And General | $5,573 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,138 | TotalAmt |
| Program Services | $20,812 | ProgramServicesAmt |
| Management And General | $28,555 | ManagementAndGeneralAmt |
| Fundraising | $2,771 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,938 | TotalAmt |
| Program Services | $138,945 | ProgramServicesAmt |
| Management And General | $42,536 | ManagementAndGeneralAmt |
| Fundraising | $457 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,636 | TotalAmt |
| Program Services | $100 | ProgramServicesAmt |
| Management And General | $38,536 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $906,682 | $906,682 | $0 |
| CLINICAL SUPPLIES | $184,832 | $184,702 | $130 |
| SMALL EQUIPMENT | $21,858 | $18,675 | $3,183 |
| DUES & SUBSCRIPTIONS | $11,554 | $778 | $10,776 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,188 | TotalAmt |
| Program Services | $14,902 | ProgramServicesAmt |
| Management And General | $7,286 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,044,139 | TotalAmt |
| Program Services | $4,668,382 | ProgramServicesAmt |
| Management And General | $1,266,682 | ManagementAndGeneralAmt |
| Fundraising | $109,075 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,652 | BOYAmt |
| EOY | $852,621 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,632 | BOYAmt |
| EOY | $485,159 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,127 | BOYAmt |
| EOY | $55,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $450,274 | BOYAmt |
| EOY | $315,370 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,340 | BOYAmt |
| EOY | $75,767 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,369,439 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $565,981 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $969,376 | BOYAmt |
| EOY | $803,458 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,699,401 | BOYAmt |
| EOY | $2,587,375 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $354,961 | BOYAmt |
| EOY | $256,481 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,085 | BOYAmt |
| EOY | $21,539 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $369,046 | BOYAmt |
| EOY | $278,020 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,247,961 | BOYAmt |
| EOY | $2,028,085 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,394 | BOYAmt |
| EOY | $281,270 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,330,355 | BOYAmt |
| EOY | $2,309,355 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,699,401 | BOYAmt |
| EOY | $2,587,375 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $979,082 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$82 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,664,756 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,114,329 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,749,641 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,755,689 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,931,945 | CurrentTaxYearAmt |
| Total | $12,216,360 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,664,756 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,114,329 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,749,641 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,755,689 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,931,945 | CurrentTaxYearAmt |
| Total | $12,216,360 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $12,216,360 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $77 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,350 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,910 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,476 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $605 | CurrentTaxYearAmt |
| Total | $14,418 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,977 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $205,759 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $99,320 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $125,048 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $222,778 | CurrentTaxYearAmt |
| Total | $657,882 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $12,888,660 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $12,172,363 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.94780 | PublicSupportCY170Pct |
| Public Support PY170 | 0.95980 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME MEANINGFUL USE INSURANCE REIMBURSEMENTS | ExplanationTxt |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $478,049 | OtherCostOrOtherBasisAmt |
| Depreciation | $134,451 | DepreciationAmt |
| Book Value | $343,598 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $191,193 | OtherCostOrOtherBasisAmt |
| Depreciation | $159,265 | DepreciationAmt |
| Book Value | $31,928 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $700,197 | OtherCostOrOtherBasisAmt |
| Depreciation | $272,265 | DepreciationAmt |
| Book Value | $427,932 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $803,458 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,023,139 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$82 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$82 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,023,221 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,023,221 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,044,139 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,044,139 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,044,139 | TotalExpensesPerForm990Amt |
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 FASB 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | PATIENT NON-MEDICAL FINANCIAL ASSISTANCE | GrantTypeTxt |
| Cash Grant | $5,890 | CashGrantAmt |
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 A 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 FUNDS 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STUART CURRIE MD | PersonNm |
| Title | CMO | TitleTxt |
| Base Compensation Filing Org | $270,516 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $3,712 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $4,435 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $278,663 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, 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 AND THE FINANCE COMMITTEE. A COPY OF THE FORM 990 WAS 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, THE 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 2018. THE SALARY OF THE CHIEF FINANCIAL OFFICER IS DETERMINED BY THE CHIEF EXECUTIVE OFFICER AFTER A REVIEW OF THE NON-PROFIT AND HEALTH CENTER SALARY SURVEY FOR THE REGION. THE PROCESS WAS LAST COMPLETED IN 2018. |
| 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. |