WAYNE MEMORIAL COMMUNITY HEALTH CENTERS: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- WAYNE MEMORIAL COMMUNITY HEALTH CENTERS (EIN 23-2180889)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-02
- IRS object ID
- 201111229349300116
- Schema version
- 2009v1.7
- 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) |
|---|---|---|
| Timestamp | 2011-05-02T10:45:07-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ParenteBeard LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 46 Public Square Suite 400 | AddressLine1 |
| City | WilkesBarre | City |
| State | PA | State |
| ZIP Code | 18701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232180889 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE MEMORIAL COMMUNITY HEALTH CENTERS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WAYN | NameControl |
| Phone | 5702531300 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 PARK STREET | AddressLine1 |
| City | HONESDALE | City |
| State | PA | State |
| ZIP Code | 18431 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Frederick Jackson | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 5702531300 | Phone |
| Date Signed | 2011-04-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Julius Green CPA | Name |
| Phone | 5708200100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Frederick Jackson | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 PARK STREET | AddressLine1 |
| City | HONESDALE | City |
| State | PA | State |
| ZIP Code | 18431 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 8472803 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.wmh.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1981 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | Medical, Dental, and Behavioral health services to the residents of the Wayne & Pike Counties of PA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 104 | TotalNbrEmployees |
| Total Nbr Volunteers | 3 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1498593 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1964355 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3803803 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6484068 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 246 | InvestmentIncomePriorYear |
| Investment Income Current Year | 114 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 8119 | OtherRevenuePriorYear |
| Other Revenue Current Year | 12669 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5310761 | TotalRevenuePriorYear |
| Total Revenue Current Year | 8461206 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 3935404 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5940236 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1477999 | OtherExpensePriorYear |
| Other Expenses Current Year | 1895615 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 5413403 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7835851 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -102642 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 625355 | RevenuesLessExpensesCY |
| Total Assets BOY | 1703276 | TotalAssetsBOY |
| Total Assets EOY | 3022876 | TotalAssetsEOY |
| Total Liabilities BOY | 1310168 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2004413 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 393108 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1018463 | NetAssetsOrFundBalancesEOY |
| Mission Description | The mission is to provide medical, dental and behavioral health services to all the residents of Wayne & Pike counties Pennsylvania with a specific emphasis on the underserved, low income and uninsured. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 7084444 | Expense |
| Revenue | 6494071 | Revenue |
| Description | Serving all members of the community with a focus on the underserved and disadvantaged, the Wayne Memorial Community Health Centers will create and sustain a healthy community by providing high quality primary medical, dental, and behavioral health care in an accessible, affordable and nondiscriminatory manner. In the year ending 2010 WMCHC provided 25,814 medical encounters, 11,478 dental encounters, and 1,670 behavioral encounters to the residents of Wayne and Pike Counties. WMCHC continues to grow and add practitioners and service locations in order to provide quality medical, dental, and behavioral health services. Services are provided through eight medical, one behavioral health, and one dental office. We relieve government burden by providing care to Medicaid and uninsured individuals who would be destitute and lacking proper care without our interventions. In fiscal 2010, Wayne Community Health Centers provided approximately $276,878 in charitable care services. | Description |
| Total Program Service Expense | 7084444 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 21 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 104 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | PA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Administration | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5702538100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 PARK STREET | AddressLine1 |
| City | HONESDALE | City |
| State | PA | State |
| ZIP Code | 18431 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Steve Burlein | ||||||||
| Member | 1.00 | X | 0 | 0 | 0 | |||
| Doreen Fitzgerald | ||||||||
| Member | 1.00 | X | 0 | 0 | 0 | |||
| Ann Foster | ||||||||
| Member | 1.00 | X | 0 | 0 | 0 | |||
| Susan Gabrielson | ||||||||
| Member | 1.00 | X | 0 | 0 | 0 | |||
| David Hoff | ||||||||
| Member | 1.00 | X | 0 | 0 | 0 | |||
| Maria Shelp | ||||||||
| Member | 1.00 | X | 0 | 0 | 0 | |||
| Justin O'Donnell | ||||||||
| Chair | 1.00 | X | 0 | 0 | 0 | X | ||
| Peter Rodgers | ||||||||
| Vice-Chair | 1.00 | X | 0 | 0 | 0 | X | ||
| Michael Clifford | ||||||||
| Treasurer | 1.00 | X | 0 | 0 | 0 | X | ||
| Sandy Maxson | ||||||||
| Secretary | 1.00 | X | 0 | 0 | 0 | X | ||
| Frederick Jackson | ||||||||
| Executive Director | 1.00 | 125097 | 0 | 18827 | X | |||
| Dr ROBERT GORRELL | ||||||||
| PHYSICIAN | 40.00 | 297952 | 0 | 20225 | X | |||
| Dr SEAN MCVEIGH | ||||||||
| PHYSICIAN | 40.00 | 256916 | 0 | 26770 | X | |||
| Dr ROBERT DOHNOR | ||||||||
| PHYSICIAN | 40.00 | 170589 | 0 | 20077 | X | |||
| Pedro Mencia | ||||||||
| Physician | 40.00 | 254344 | 0 | 18921 | X | |||
| Hoon Yoo | ||||||||
| PhySICIAN | 40.00 | 254792 | 0 | 17420 | X | |||
| Catalina Dinu | ||||||||
| PhysICIAN | 40.00 | 165412 | 0 | 4692 | X | |||
| Brian Brown | ||||||||
| PhySICIAN | 40.00 | 106788 | 0 | 4080 | X | |||
| Wawrzyniec Stepczak | ||||||||
| physicIAN | 40.00 | 131117 | 0 | 11226 | X | |||
| John Weisenreider | ||||||||
| PhysiCIAN | 40.00 | 127242 | 0 | 15108 | X | |||
| Vance Jones | ||||||||
| PhysiciaN | 40.00 | 121722 | 0 | 18599 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2011971 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 175945 | TotalOtherCompensation |
| Number Individuals GT100 K | 11 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Charles W Grimm Construction Inc | |||||
| 228 NEW STREET | Waymart | PA | 18472 | Construction Work | 318188 |
| VIRTUAL OFFICEWARE INC | |||||
| 111 RYAN COURT SUITE 200 | PITTSBURGH | PA | 15205 | SOFTWARE SUPPORT | 133672 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Government Grants | 1954754 | GovernmentGrants |
| All Other Contributions | 9601 | AllOtherContributions |
| Total Contributions | 1964355 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE RE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 6484068 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6484068 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6484068 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 266 | TotalRevenueColumn |
| Exclusion | $266 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 13959 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 11445 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2514 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2514 | TotalRevenueColumn |
| Exclusion | $2,514 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 152 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -152 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -152 | TotalRevenueColumn |
| Related Or Exempt Function Income | -152 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Miscellaneous Contract | 900099 | 9783 | 9783 |
| PURCHASE DISCOUNTS | 900099 | 372 | 372 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 10155 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8461206 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6494071 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,780 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143924 | Total |
| Management And General | 143924 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4770193 | Total |
| Program Services | 4539418 | ProgramServices |
| Management And General | 230775 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 192817 | Total |
| Program Services | 178115 | ProgramServices |
| Management And General | 14702 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 528969 | Total |
| Program Services | 488635 | ProgramServices |
| Management And General | 40334 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 304333 | Total |
| Program Services | 278780 | ProgramServices |
| Management And General | 25553 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40194 | Total |
| Program Services | 549 | ProgramServices |
| Management And General | 39645 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34149 | Total |
| Management And General | 34149 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43546 | Total |
| Program Services | 42882 | ProgramServices |
| Management And General | 664 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 524585 | Total |
| Program Services | 505763 | ProgramServices |
| Management And General | 18822 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 408396 | Total |
| Program Services | 400429 | ProgramServices |
| Management And General | 7967 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4013 | Total |
| Program Services | 4013 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21832 | Total |
| Management And General | 21832 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72478 | Total |
| Program Services | 70288 | ProgramServices |
| Management And General | 2190 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 100866 | Total |
| Program Services | 100866 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED SERVICES | 323249 | 173465 | 149784 |
| BAD DEBT EXPENSE | 218888 | 218888 | |
| OUTSIDE TRAINING | 52462 | 40579 | 11883 |
| Repairs and Maintenance | 24157 | 24157 | |
| DUES | 22847 | 13664 | 9183 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3953 | Total |
| Program Services | 3953 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7835851 | Total |
| Program Services | 7084444 | ProgramServices |
| Management And General | 751407 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 125834 | BOY |
| EOY | 117766 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37518 | BOY |
| EOY | 62683 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 711871 | BOY |
| EOY | 725598 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91965 | BOY |
| EOY | 56018 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1019889 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 214885 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 354000 | BOY |
| EOY | 805004 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 382088 | BOY |
| EOY | 1255807 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1703276 | BOY |
| EOY | 3022876 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 668773 | BOY |
| EOY | 870970 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 491000 | BOY |
| EOY | 1050000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 150395 | BOY |
| EOY | 83443 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1310168 | BOY |
| EOY | 2004413 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 375801 | BOY |
| EOY | 1018463 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17307 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 393108 | BOY |
| EOY | 1018463 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1703276 | BOY |
| EOY | 3022876 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 240798839 | EIN |
| Type Of Organization | 7 | TypeOfOrganization |
| Listed In Governing Doc | 0 | ListedInGoverningDoc |
| Organized In US | 1 | OrganizedInUS |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 365467 | InvestmentCostOrOtherBasis |
| Depreciation | 12849 | Depreciation |
| Book Value | 352618 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 552894 | InvestmentCostOrOtherBasis |
| Depreciation | 202036 | Depreciation |
| Book Value | 350858 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 101528 | InvestmentCostOrOtherBasis |
| Book Value | 101528 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 805004 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Estimated third-party settlements | Description |
| Book Value | 1255807 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1255807 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO WAYNE MEMORIAL HOSPITAL | Description |
| Amount | $83,443 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 83443 | TotalOfAmounts |
| Total Revenue | 8461206 | TotalRevenue |
| Total Expenses | 7835851 | TotalExpenses |
| Excess Or Deficit For Year | 625355 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 625355 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 8472651 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 8472651 | RevenueSubtotal |
| Other Revenues Not Included | -11445 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -11445 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 8461206 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7847296 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 11445 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 11445 | ExpensesNotRptdF990 |
| Expenses Subtotal | 7835851 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 7835851 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | Part X: The Corporation is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on its exempt income under Section 501(a) of the Internal Revenue Code. The Corporation applies the authoritative guidance related to the recognition of uncertain tax benefits. Accordingly, a provision for uncertain tax positions and related penalties and interest is recognized when it is probable that a liability was incurred and the amount can be reasonably estimated. Critical estimates with respect to income taxes are disclosed when it is at least reasonably possible that a change in estimate will occur in the near term. |
| Part XII, Line 4b - Other Adjustments: | RENTAL EXPENSES: -11445. | |
| Part XIII, Line 2d - Other Adjustments: | RENTAL EXPENSES: 11445. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dr ROBERT GORRELL | |||||||||||||
| 297952 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 20225 | 0 | 318177 | 0 | 0 | 0 |
| Dr SEAN MCVEIGH | |||||||||||||
| 256916 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 26770 | 0 | 283686 | 0 | 0 | 0 |
| Dr ROBERT DOHNOR | |||||||||||||
| 170589 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 20077 | 0 | 190666 | 0 | 0 | 0 |
| Pedro Mencia | |||||||||||||
| 254344 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 18921 | 0 | 273265 | 0 | 0 | 0 |
| Hoon Yoo | |||||||||||||
| 254792 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 17420 | 0 | 272212 | 0 | 0 | 0 |
| Catalina Dinu | |||||||||||||
| 165412 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4692 | 0 | 170104 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | PETER RODGERS | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | BOARD MEMBER AND INSURANCE BROKER | Relationship |
| Amount Of Transaction | 61000 | AmountOfTransaction |
| Description Of Transaction | PROVIDES D&O LIABILITY INSURANCE FOR WAYNE MEMORIAL HEALTH SYSTEMS, A RELATED ORGANIZATION | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | QUESTIONNAIRES ARE SENT TO EVERY BOARD MEMBER. MICHAEL CLIFFORD IS AN EMPLOYEE OF WAYNE MEMORIAL HEALTH SYSTEMS, A RELATED ORGANIZATION. DAVID HOFF IS AN EMPLOYEE OF WAYNE MEMORIAL HEALTH SYSTEMS, A RELATED ORGANIZATION. |
| Form 990, Part VI, Section A, line 3 | THE WAYNE COMMUNITY HEALTH CENTERS PAY MANAGEMENT FEES FOR SUPPORT SERVICES TO WAYNE MEMORIAL HEALTH SYSTEM INC. |
| Form 990, Part VI, Section B, line 11 | An e-mail is distributed to all board members before the 990 is filed for their review. The 990 will be discussed and reviewed at the following full board meeting. |
| Form 990, Part VI, Section B, line 12c | Conflict of interest statements are completed by every board member and manager annually. Each individual signs and returns the statements to the administration office. |
| Form 990, Part VI, Section B, line 15 | 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 19 | Form 990, Part VI, Section C, Line 19: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND/OR FINANCIAL STATEMENTS AVAILABLE TO PUBLIC UPON REQUEST. |
| THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT, NO CHANGE FROM PRIOR YEARS. |