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WAYNE MEMORIAL COMMUNITY HEALTH CENTERS: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS (EIN 23-2180889)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-15
IRS object ID
201711359349307281
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-05-15T13:33:52-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN232180889EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WAYNE MEMORIAL COMMUNITY HEALTH CENTERSBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% FREDERICK JACKSONInCareOfNm
Business Name ControlWAYNBusinessNameControlTxt
Phone5702516676PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1601 PARK STREETAddressLine1Txt
CityHONESDALECityNm
State AbbreviationPAStateAbbreviationCd
ZIP18431ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonFREDERICK JACKSONPersonNm
Person TitleCEOPersonTitleTxt
Signature2017-01-31SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone4178658701PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerFREDERICK JACKSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1601 PARK STREETAddressLine1Txt
CityHONESDALECityNm
State AbbreviationPAStateAbbreviationCd
ZIP18431ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$23,699,615GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WMH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1981FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionMEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES TO THE RESIDENTS OF THE WAYNE, PIKE, UPPER LACKAWANNA AND PART OF SUSQUEHANNA COUNTIES OF PENNSYLVANIA.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee215TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,181,934PYContributionsGrantsAmt
CY Contributions Grants$4,514,513CYContributionsGrantsAmt
PY Program Service Revenue$12,344,975PYProgramServiceRevenueAmt
CY Program Service Revenue$19,131,522CYProgramServiceRevenueAmt
PY Investment Income$4,872PYInvestmentIncomeAmt
CY Investment Income$5,562CYInvestmentIncomeAmt
PY Other Revenue$13,306PYOtherRevenueAmt
CY Other Revenue$9,603CYOtherRevenueAmt
PY Total Revenue$15,545,087PYTotalRevenueAmt
CY Total Revenue$23,661,200CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,903,161PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,725,197CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,744,134PYOtherExpensesAmt
CY Other Expenses$4,673,783CYOtherExpensesAmt
PY Total Expenses$15,647,295PYTotalExpensesAmt
CY Total Expenses$21,398,980CYTotalExpensesAmt
PY Revenues Less Expenses-$102,208PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,262,220CYRevenuesLessExpensesAmt
Total Assets BOY$5,148,014TotalAssetsBOYAmt
Total Assets EOY$7,574,996TotalAssetsEOYAmt
Total Liabilities BOY$2,425,514TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,590,276TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,722,500NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,984,720NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION IS TO PROVIDE MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES TO THE RESIDENTS OF WAYNE, PIKE, UPPER LACKAWANNA AND PART OF SUSQUEHANNA COUNTIES OF PENNSYLVANIA WITH A SPECIFIC EMPHASIS ON THE UNDERSERVED, LOW INCOME AND UNINSURED.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$8,132,598ExpenseAmt
Revenue$9,669,561RevenueAmt
DescWAYNE MEMORIAL COMMUNITY HEALTH CENTERS PROVIDES HIGH QUALITY PRIMARY CARE SERVICES THROUGH ITS FAMILY HEALTH CLINICS TO THE RESIDENTS OF WAYNE AND PIKE COUNTIES. THE FAMILY HEALTH CLINICS ARE LOCATED IN HONESDALE, LAKE COMO, WAYMART, LORDS VALLEY, VANDLING, HAMLIN, TAFTON AND CARBONDALE, PROVIDING OUTPATIENT PRIMARY CARE SERVICES FOR CHILDREN AND ADULTS. SEE SCHEDULE O FOR MORE INFORMATION.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,666,100ExpenseAmt
Revenue$2,646,215RevenueAmt
DescWAYNE MEMORIAL COMMUNITY HEALTH CENTERS PROVIDES COMPREHENSIVE DENTAL CARE THROUGH ITS DENTAL CLINIC FOR CHILDREN AND ADULTS AT THE TOGETHER FOR HEALTH DENTAL CENTER IN HONESDALE AND THE PIKE DENTAL CENTER IN LORDS VALLEY. BOTH SITES ARE FULLY DIGITAL ALLOWING X-RAY IMAGES TO BE VIEWED BY THE DENTAL TEAM INSTANTLY. ADVANCED EQUIPMENT CALLED PANORAMIC RADIOLOGY PERFORMS TWO DIMENSIONAL EXAMINATIONS OF THE ENTIRE MOUTH WITH ONLY A SINGLE IMAGE. SEE SCHEDULE O FOR MORE INFORMATION.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$2,566,642ExpenseAmt
Revenue$2,954,530RevenueAmt
DescWAYNE MEMORIAL COMMUNITY HEALTH CENTERS PROVIDES WOMEN'S HEALTH SERVICES THROUGH ITS WOMEN'S HEALTH CLINIC. THESE SERVICES INCLUDE OBSTETRICAL AND GYNECOLOGICAL SERVICES WITH BOARD-CERTIFIED AND BOARD-ELIGIBLE PHYSICIANS, CERTIFIED NURSE-MIDWIVES, ULTRASOUND TECHNOLOGISTS AND REGISTERED NURSES IN HONESDALE, HAMLIN, LORDS VALLEY, WAYMART, CARBONDALE AND VANDLING. SEE SCHEDULE O FOR MORE INFORMATION.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$4,687,195TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$3,861,216TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$18,052,535TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document39IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee215EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonFREDERICK JACKSONPersonNm
Phone5702516676PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1601 PARK STREETAddressLine1Txt
CityHONESDALECityNm
State AbbreviationPAStateAbbreviationCd
ZIP18431ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
PETER RODGERS
CHAIRMAN1.00.0Yes (X)Yes (X)$0$0$0
MICHAEL CLIFFORD
TREASURER1.00.0Yes (X)Yes (X)$0$0$0
SUSAN GABRIELSON
SECRETARY1.00.0Yes (X)Yes (X)$0$0$0
STEVE BURLEIN
VICE CHAIRMAN1.00.0Yes (X)Yes (X)$0$0$0
ANN FOSTER
BOARD MEMBER1.00.0Yes (X)$0$0$0
WILLIAM KERL
BOARD MEMBER1.00.0Yes (X)$0$0$0
DAVID HOFF
BOARD MEMBER1.00.0Yes (X)$0$0$0
WILLIAM SCHWEIGHOFER
BOARD MEMBER1.00.0Yes (X)$0$0$0
STEVE TOURJE
BOARD MEMBER1.00.0Yes (X)$0$0$0
WALTER SMITH
BOARD MEMBER1.00.0Yes (X)$0$0$0
DR CARRIE DEMERS
BOARD MEMBER1.00.0Yes (X)$0$0$0
FREDERICK JACKSON
CEO40.00.0Yes (X)$158,017$0$28,181
JOHN WEISENREIDER
MEDICAL DIRECTOR40.00.0$189,649$0$25,390Yes (X)
MICHAEL CAMPBELL
BEHAVIORAL DIRECTOR40.00.0$215,536$0$31,948Yes (X)
BRIAN BROWN
DENTAL DIRECTOR40.00.0$184,446$0$26,029Yes (X)
SEAN MCVEIGH
PHYSICIAN40.00.0$267,670$0$28,623Yes (X)
BRIAN LENCZEWSKI
PHYSICIAN40.00.0$275,595$0$27,298Yes (X)
SALVADOR GUERRERO
PHYSICIAN40.00.0$268,856$0$35,248Yes (X)
MEHRAN HAMZEH LANGROUDI
PHYSICIAN40.00.0$225,498$0$33,148Yes (X)
RAYMOND RESNICK
PHYSICIAN40.00.0$224,050$0$3,531Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,009,317TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$239,396TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K25IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonWAYNE MEMORIAL HEALTH SYSTEMPersonNm
FieldValueIRS element (for citing)
Contractor AddressContractorAddress
ServicesADMINISTRATIVE SVCSServicesDesc
Compensation$132,000CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$1,532,913GovernmentGrantsAmt
All Other Contributions$2,981,600AllOtherContributionsAmt
Noncash Contributions$318,000NoncashContributionsAmt
Total Contributions$4,514,513TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$18,396,736$18,396,736
OTHER INCOME900099$329,009$329,009
CAPITATION REVENUE900099$405,777$405,777
FieldValueIRS element (for citing)
Total Program Service Revenue$19,131,522TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,562TotalRevenueColumnAmt
Exclusion$5,562ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$48,018RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$38,415RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$9,603RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,603TotalRevenueColumnAmt
Exclusion$9,603ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,661,200TotalRevenueColumnAmt
Related Or Exempt Func Income$19,131,522RelatedOrExemptFuncIncomeAmt
Exclusion$15,165ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$859,196TotalAmt
Program Services$672,998ProgramServicesAmt
Management And General$186,198ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,710,161TotalAmt
Program Services$10,820,733ProgramServicesAmt
Management And General$1,889,428ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$489,213TotalAmt
Program Services$417,887ProgramServicesAmt
Management And General$71,326ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,808,933TotalAmt
Program Services$1,541,834ProgramServicesAmt
Management And General$267,099ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$857,694TotalAmt
Program Services$727,206ProgramServicesAmt
Management And General$130,488ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$23,509TotalAmt
Management And General$23,509ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$37,741TotalAmt
Management And General$37,741ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$804,635TotalAmt
Program Services$570,301ProgramServicesAmt
Management And General$234,334ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$27,321TotalAmt
Program Services$23,164ProgramServicesAmt
Management And General$4,157ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,526,910TotalAmt
Program Services$1,294,609ProgramServicesAmt
Management And General$232,301ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$901,924TotalAmt
Program Services$764,707ProgramServicesAmt
Management And General$137,217ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$13,782TotalAmt
Program Services$11,685ProgramServicesAmt
Management And General$2,097ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$77,124TotalAmt
Program Services$65,391ProgramServicesAmt
Management And General$11,733ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$21,723TotalAmt
Program Services$18,418ProgramServicesAmt
Management And General$3,305ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$454,037TotalAmt
Program Services$384,961ProgramServicesAmt
Management And General$69,076ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$149,391TotalAmt
Program Services$126,663ProgramServicesAmt
Management And General$22,728ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT$479,847$479,847
REPAIRS & MAINTENANCE$62,754$53,207$9,547
LICENSES, DUES, SUBSCRIPTIONS$53,257$45,155$8,102
MEDICAL SUPPLIES & DRUGS$39,828$33,769$6,059

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$21,398,980TotalAmt
Program Services$18,052,535ProgramServicesAmt
Management And General$3,346,445ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$29,616BOYAmt
EOY$65,114EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$517,506BOYAmt
EOY$1,508,016EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$294,730BOYAmt
EOY$554,213EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,268,159BOYAmt
EOY$2,448,676EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$87,026BOYAmt
EOY$106,370EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$4,679,201LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,132,052LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,713,857BOYAmt
EOY$2,547,149EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$197,010EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$237,120BOYAmt
EOY$148,448EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,148,014BOYAmt
EOY$7,574,996EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,691,147BOYAmt
EOY$1,933,909EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$734,367BOYAmt
EOY$380,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$276,367EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,425,514BOYAmt
EOY$2,590,276EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,722,500BOYAmt
EOY$4,984,720EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,722,500BOYAmt
EOY$4,984,720EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,148,014BOYAmt
EOY$7,574,996EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,262,220ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd
Public Support CY5090.00000PublicSupportCY509Pct

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$1,250OtherActivitiesAmt
Total Lobbying Expenditures$1,250TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationOTHER LOBBYING ACTIVITIES: WAYNE MEMORIAL COMMUNITY HEALTH CENTERS PAYS ANNUAL MEMBERSHIP DUES TO PENNSYLVANIA ASSOCIATION OF COMMUNITY HEALTH CENTERS (PACHC). THE ORGANIZATION IS NOTIFIED EACH YEAR THAT A PORTION OF THE MEMBERSHIP DUES IS USED FOR LOBBYING ACTIVITIES. FOR THE FISCAL YEAR ENDED JUNE 30, 2016 THE PORTION OF DUES PAID REPRESENTING LOBBYING EXPENDITURES WAS $1,250.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,140,878OtherCostOrOtherBasisAmt
Depreciation$499,567DepreciationAmt
Book Value$1,641,311BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,538,323OtherCostOrOtherBasisAmt
Depreciation$1,632,485DepreciationAmt
Book Value$905,838BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$2,547,149TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO RELATED PARTY$10,632
DUE TO THIRD PARTY PAYERS$265,735
FieldValueIRS element (for citing)
Total Liability$276,367TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$23,219,768TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$479,847OtherRevenueAmt
Revenue Not Reported-$479,847RevenueNotReportedAmt
Revenue Subtotal$23,699,615RevenueSubtotalAmt
Other Revenues Not Included-$38,415OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$38,415RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$23,661,200TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,957,548TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$38,415OtherExpensesIncludedAmt
Expenses Not Reported$38,415ExpensesNotReportedAmt
Expenses Subtotal$20,919,133ExpensesSubtotalAmt
Other Expenses Not Included$479,847OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$479,847ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$21,398,980TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2DAMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ (479,847) BAD DEBT EXPENSE
SCHEDULE D, PART XI, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ ( 38,415) RENTAL EXPENSES
SCHEDULE D, PART XI, LINE 4BAMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 38,415 RENTAL EXPENSES
SCHEDULE D, PART XII, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25 BUT NOT ON LINE 1: $ 479,847 BAD DEBT EXPENSE

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
FREDERICK JACKSON
CEO$137,983$0$9,600$0$10,434$0$8,833$0$19,348$0$186,198$0$0$0
SEAN MCVEIGH
PHYSICIAN$267,445$0$225$0$0$0$9,275$0$19,348$0$296,293$0$0$0
BRIAN LENCZEWSKI
PHYSICIAN$253,870$0$21,725$0$0$0$7,950$0$19,348$0$302,893$0$0$0
SALVADOR GUERRERO
PHYSICIAN$263,631$0$5,225$0$0$0$15,900$0$19,348$0$304,104$0$0$0
MEHRAN HAMZEH LANGROUDI
PHYSICIAN$222,255$0$3,243$0$0$0$13,800$0$19,348$0$258,646$0$0$0
RAYMOND RESNICK
PHYSICIAN$224,050$0$0$0$0$0$0$0$3,531$0$227,581$0$0$0
JOHN WEISENREIDER
MEDICAL DIRECTOR$182,824$0$6,825$0$0$0$8,497$0$16,893$0$215,039$0$0$0
MICHAEL CAMPBELL
BEHAVIORAL DIRECTOR$206,259$0$9,277$0$0$0$12,600$0$19,348$0$247,484$0$0$0
BRIAN BROWN
DENTAL DIRECTOR$126,613$0$57,833$0$0$0$7,740$0$18,289$0$210,475$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 7FormAndLineReferenceDesc
ExplanationNON-FIXED PAYMENTS: BONUSES ARE ARE BASED ON PRODUCTIVITY. MEDICAL PROVIDER BONSUSES ARE BASED ON PATIENT ENCOUNTERS, WHILE DENTAL PROVIDER BONUSES ARE BASED ON A PERCENTAGE OF GROSS CHARGES LESS BASE SALARY.ExplanationTxt

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp
Clothing And Household GoodsClothingAndHouseholdGoodsGrp
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp
Securities Publicly TradedSecuritiesPubliclyTradedGrp
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp
CollectiblesCollectiblesGrp
Food InventoryFoodInventoryGrp
Drugs And Medical SuppliesDrugsAndMedicalSuppliesGrp
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescSEE PART IIDesc
Contribution1ContributionCnt
Noncash Contributions Rpt F990$318,000NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE M, PART I, LINE 25FormAndLineReferenceDesc
ExplanationOTHER NONCASH CONTRIBUTIONS: During fiscal year 2016, WAYNE MEMORIAL HOSPITAL entered into Asset Purchase Agreements with two separate clinics in order to obtain certain assets as well as patient records. These two clinic acquisitions were then contributed to Wayne memorial community health centers. Wayne memorial hospital contributed assets of Highland Physicians, LTD including all property, plant and equipment, inventory, fixtures, furniture, medical and other equipment, vehicles, computer hardware and software, supplies and office materials, and patient medical records. Wayne memorial hospital contributed assets of Pinnacle Health Partners, Inc, including all property, plant and equipment, inventory, fixtures, furniture, medical and other equipment, vehicles, computer hardware and software, supplies and office materials, and patient medical records.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 4APROGRAM SERVICE ACTIVITY #1: THE FULL RANGE OF OUTPATIENT PRIMARY CARE SERVICES PROVIDED BY THE WAYNE MEMORIAL COMMUNITY HEALTH CENTERS FAMILY CARE CLINICS FOR CHILDREN AND ADULTS INCLUDE: -EXAMS -DIAGNOSIS AND TREATMENT OF ACUTE AND CHRONIC CONDITIONS -EKG -SUTURING OF MINOR LACERATIONS -MINOR SURGERY -DIABETES AND NUTRITION COUNSELING -ADULT AND CHILDHOOD IMMUNIZATIONS -WELL-CHILD VISITS -SPORTS PHYSICALS -SCHOOL PHYSICALS -CDL EXAMS -WELL-WOMAN EXAMS -PREVENTATIVE CARE -SMOKING CESSATION THESE SERVICES ARE PROVIDED BY BOARD-CERTIFIED INTERNISTS, FAMILY MEDICINE PHYSICIANS, BOARD-CERTIFIED PEDIATRICIANS, CERTIFIED REGISTERED NURSE PRACTITIONERS AND CERTIFIED PHYSICIAN ASSISTANTS.
FORM 990, PART III, LINE 4BPROGRAM SERVICE ACTIVITY #2: THE FULL RANGE OF SERVICES PROVIDED BY THE WAYNE MEMORIAL COMMUNITY HEALTH CENTERS DENTAL CLINICS INCLUDE: -DENTAL EXAMS -PREVENTATIVE TREATMENT -PERIODONTAL TREATMENT -RESTORATIVE PROCEDURES -DENTURES, PARTIALS AND FIXED BRIDGES -DENTAL EDUCATION PREVENTATIVE MOBILE DENTAL SERVICES ARE OFFERED TO COMMUNITIES WITH EITHER LIMITED OR NO ACCESS TO DENTAL CARE. A PUBLIC HEALTH DENTAL HYGIENE PRACTITIONER/COMMUNITY DENTAL HEALTH COORDINATOR, A DENTAL HEALTH PROFESSIONAL WHO HAS COMPLETED A PROGRAM SPONSORED BY THE AMERICAN DENTAL ASSOCIATION, PERFORMS DENTAL SERVICES INCLUDING CLEANINGS, FLUORIDE TREATMENTS, SEALANTS AND X-RAYS FOR CHILDREN AND ADULTS WHILE VISITING AREA PHYSICIAN OFFICES, SCHOOLS AND HEAD START PROGRAMS.
FORM 990, PART III, LINE 4CPROGRAM SERVICE ACTIVITY #3: THE FULL RANGE OF SERVICES PROVIDED BY THE WAYNE MEMORIAL COMMUNITY HEALTH CENTERS WOMEN'S CLINIC INCLUDES: -WELL-TEEN AND WELL-WOMAN CARE -UTERINE ABLATION -URODYNAMIC TESTING -HORMONE REPLACEMENT THERAPY COUNSELING -PERIMENOPAUSAL COUNSELING -NONINVASIVE HEREDITARY CANCER TESTING -PRENATAL CARE -ULTRASOUND -PRECONCEPTION COUNSELING -PRENATAL FITNESS -CHILDBIRTH EDUCATION -LACTATION COUNSELING THE WOMEN'S HEALTH CLINIC PARTICIPATES IN STATE-FUNDED PROGRAMS SUCH AS HEALTHY BEGINNINGS PLUS AND OFFERS SERVICES TO ALL, INCLUDING THOSE WITH PRIVATE INSURANCE OR ON PUBLIC ASSISTANCE. A SLIDING SCALE IS ALSO OFFERED BASED ON INCOME.
FORM 990, PART III, LINE 4DOTHER PROGRAM SERVICES: WAYNE MEMORIAL COMMUNITY HEALTH CENTERS PROVIDES A VARIETY OF OTHER SERVICES, INCLUDING GENERAL SURGERY, PULMONARY AND SLEEP MEDICINE, AND BEHAVIORAL HEALTH, INCLUDING MENTAL HEALTH AND COUNSELING SERVICES, AT THE BEHAVIORAL HEALTH CENTER IN HONESDALE AND PIKE COUNTY. GENERAL SURGERY SERVICES ARE PROVIDED BY A BOARD-ELIGIBLE GENERAL SURGEON AND A BOARD CERTIFIED GENERAL SURGEON/BOARD-ELIGIBLE VASCULAR SURGEON IN HONESDALE AND THE PIKE COUNTY FAMILY HEALTH CENTER. PULMONARY AND SLEEP MEDICINE ARE PROVIDED THROUGH THE SLEEP DISORDERS CENTERS. POLYSOMNOGRAMS ARE PAINLESS, NON-INVASIVE TESTS DURING WHICH HIGHLY TRAINED TECHNOLOGISTS MONITOR BREATHING, HEART RATE, BLOOD OXYGEN LEVELS, EYE MOVEMENT, MUSCLE TONE AND OTHER FACTORS THROUGHOUT ONE FULL NIGHT OF SLEEP. THE SLEEP CENTER SIMULATES A COMFORTABLE HOME ENVIRONMENT WHICH GENERALLY MAKE IT EASIER TO FALL ASLEEP SO THAT SLEEP PATTERN INFORMATION CAN BE COLLECTED AND INTERPRETED. THE INFORMATION COLLECTED IS THEN SENT TO THE PATIENT'S DOCTOR. BEHAVIORAL HEALTH SERVICES ARE OFFERED AT TWO OUTPATIENT TREATMENT FACILITIES PROVIDING A FULL-RANGE OF BEHAVIORAL AND MENTAL HEALTH SERVICES TO ADULTS, ADOLESCENTS AND CHILDREN. TREATMENT SERVICES ARE AVAILABLE FOR THE FOLLOWING ISSUES: -BIPOLAR DISORDER -DEPRESSION -SCHIZOPHRENIA -PERSONALITY DISORDERS -ANXIETY -MENTAL ILLNESS -ADHD -AUTISM SPECTRUM -ANGER MANAGEMENT -SCHOOL DIFFICULTIES -GRIEF/DEATH -EATING DISORDERS -PHOBIAS -DIVORCE -SMOKING CESSATION -POST-TRAUMATIC STRESS DISORDER -OBSESSIVE COMPULSIVE DISORDER -STRESS MANAGEMENT -PREMENSTRUAL DYSPHORIC DISORDER
FORM 990, PART VI, SECTION A, LINE 2BUSINESS RELATIONSHIP: MICHAEL CLIFFORD AND DAVID HOFF SHARE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11B990 REVIEW POLICY: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A COPY OF THE 990 WILL BE DISTRIBUTED VIA E-MAIL TO EACH BOARD MEMBER BEFORE THE RETURN IS SUBMITTED TO THE IRS. MANAGEMENT WILL DISCUSS ANY QUESTIONS THAT ANY BOARD MEMBER MAY HAVE AT THE NEXT FULL BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST POLICY: CONFLICT OF INTEREST STATEMENTS ARE COMPLETED BY EVERY BOARD MEMBER AND MANAGER ANNUALLY. EACH INDIVIDUAL IS REQUIRED TO SIGN AND RETURN THE STATEMENTS TO THE ADMINISTRATION OFFICE. THE BOARD IS RESPONSIBLE FOR MONITORING COMPLIANCE WITH ANY CONFLICT OF INTEREST THROUGHOUT THE YEAR. IF A CONFLICT ARISES, THE PERSON WITH THE CONFLICT WILL RECUSE THEMSELVES FROM VOTING AND/OR DISCUSSING THE MATTER.
FORM 990, PART VI, SECTION B, LINE 15A & 15BCOMPENSATION REVIEW: WAYNE MEMORIAL COMMUNITY HEALTH CENTERS UTILIZE A COMMITTEE OF THE BOARD CALLED THE EXECUTIVE COMMITTEE TO SET COMPENSATION FOR ITS CEO. FOR OTHER KEY EMPLOYEES (DOCTORS), WAYNE MEMORIAL COMMUNITY HEALTH CENTERS USES WRITTEN EMPLOYMENT AGREEMENTS FOR THEIR COMPENSATION. THESE AGREEMENTS ARE APPROVED BY THE BOARD OR EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE IS MADE UP OF INDEPENDENT DIRECTORS WHO USE DATA FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS FOR COMPARATIVE PURPOSES. THE COMMITTEE USES THE SALARY DATA AND COMPARATIVE REVENUE, COMPLEXITY, SIZE OF FQHC, AND THE GEOGRAPHIC REGION TO DETERMINE A REASONABLE SALARY FOR THE CEO. THE EXECUTIVE COMMITTEE KEEPS MINUTES TO DOCUMENT THE DELIBERATION AND DECISION-MAKING PROCESS. THE PROCESS NORMALLY OCCURS IN OCTOBER OF THE YEAR THE COMPENSATION CHANGE IS GRANTED.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND/OR FINANCIAL STATEMENTS AVAILABLE TO PUBLIC UPON REQUEST.