2019-05-08T08:56:01-05:00 2018-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2017-07-01 232180889 WAYNE MEMORIAL COMMUNITY HEALTH CENTERS % FREDERICK JACKSON WAYN 5702516676 601 PARK STREET HONESDALE PA 18431 FREDERICK JACKSON CEO 2019-03-30 true Krystal K Creach P00422601 4178658701 167.68.126.162 43032920191285000003 2019-05-08 P 353840E92A19E57AE3D09FB5FB5D869273682438 0754179D018E36E1FC32FE9048A529C5B14E6748 2017 2019-02-21 02:37:17Z FREDERICK JACKSON 601 PARK STREET HONESDALE PA 18431 34970932 false X WWW.WMH.ORG X 1981 PA MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES TO THE RESIDENTS OF THE WAYNE, PIKE, UPPER LACKAWANNA AND PART OF SUSQUEHANNA COUNTIES OF PENNSYLVANIA. 11 11 337 12 0 4301930 5502603 25391875 29418768 2482 -7639 8633 8264 29704920 34921996 0 0 0 0 19753031 20659856 0 0 0 8339325 9841054 28092356 30500910 1612564 4421086 9388913 13772198 2791629 2753828 6597284 11018370 X THE 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. false false 15128463 15625990 WAYNE 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. 3781649 3665987 WAYNE 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. 2751481 3454102 WAYNE 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. 4172098 6672689 25833691 true true false true false false false false false false true false false true true false true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false true 55 0 true 337 true false false false false false false false false false false X 11 11 true false false false false false false true true false false true true true true true true true true false PA X FREDERICK JACKSON 5702516676 601 PARK STREET HONESDALE PA 18431 PETER RODGERS CHAIRMAN 1.0 0.0 X X 0 0 0 MICHAEL CLIFFORD TREASURER 1.0 0.0 X X 0 0 0 SUSAN GABRIELSON VICE CHAIRMAN 1.0 0.0 X X 0 0 0 ANN FOSTER BOARD MEMBER 1.0 0.0 X 0 0 0 WILLIAM KERL BOARD MEMBER 1.0 0.0 X 0 0 0 DAVID HOFF BOARD MEMBER 1.0 0.0 X 0 0 0 WILLIAM SCHWEIGHOFER SECRETARY 1.0 0.0 X X 0 0 0 STEVE TOURJE BOARD MEMBER 1.0 0.0 X 0 0 0 WALTER SMITH BOARD MEMBER 1.0 0.0 X 0 0 0 DR CARRIE DEMERS BOARD MEMBER 1.0 0.0 X 0 0 0 MICHELLE WONDERS BOARD MEMBER, BEG. 5/18 1.0 0.0 X 0 0 0 FREDERICK JACKSON CEO 40.0 0.0 X 189657 0 29572 ROBERT FORTUNER CFO 40.0 0.0 X 88394 0 12555 JOHN WEISENREIDER MEDICAL DIRECTOR 40.0 0.0 X 184860 0 28873 MICHAEL CAMPBELL BEHAVIORAL DIRECTOR 40.0 0.0 X 248723 0 34068 BRIAN BROWN DENTAL DIRECTOR 40.0 0.0 X 254049 0 30168 SEAN MCVEIGH PHYSICIAN 40.0 0.0 X 318635 0 29668 RAYMOND RESNICK PHYSICIAN 40.0 0.0 X 719728 0 23597 LOUIS C D'ORO PHYSICIAN 40.0 0.0 X 355797 0 36468 DENISE VIOLA PHYSICIAN 40.0 0.0 X 220936 0 29478 THOMAS O'BRIEN PHYSICIAN 40.0 0.0 X 240041 0 33468 2820820 0 287915 33 false true false CHARLES W GRIMM CONSTRUCTION INC PO BOX X WAYMART PA 18472 CONSTRUCTION 1192849 AMERICAN COMP WEIGHT LOSS CENTER 719 EAST LANCASTER AVE DOWNINGTOWN PA 19335 SURGERY SERVICES 280174 VIRTUAL OFFICEWARE INC 2000 CLIFF MINE ROAD PITTSBURGH PA 15275 EHR & PRACTICE MGMT 264570 POTTS SURGICAL ASSOCIATES LLC 600 CREEKSIDE DRIVE STE 611 POTTSTOWN PA 19464 SURGERY SERVICES 250915 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 SURGICAL LOCUMS 171464 8 2638728 2863875 5502603 NET PATIENT SERVICE REVENUE 621110 28495004 28495004 CAPITATION REVENUE 900099 592674 592674 OTHER INCOME 900099 331090 331090 29418768 8237 8237 0 0 41324 33060 8264 0 8264 8264 15876 -15876 -15876 0 0 0 0 0 0 0 0 0 0 34921996 29418768 16501 X 0 0 0 0 1100919 780741 320178 0 15376848 13071145 2305703 563468 482152 81316 2535912 2147962 387950 1082709 911533 171176 144000 144000 55811 55811 56527 56527 0 0 0 3852851 3364949 487902 28508 24001 4507 2055395 1730436 324959 0 0 1188007 1000183 187824 57310 48249 9061 0 85858 72284 13574 0 0 493618 415577 78041 158458 133406 25052 MEDICAL SUPPLIES & DRUGS 1277021 1277021 BAD DEBT 301425 301425 LICENSES, DUES, SUBSCRIPTIONS 58155 48961 9194 REPAIRS & MAINTENANCE 28110 23666 4444 30500910 25833691 4667219 0 1727941 5381399 954175 794977 1495086 916653 2168681 1826158 0 0 0 0 0 0 0 0 145366 165878 6466210 2982566 2481424 3483644 0 0 0 0 0 0 153230 109450 263010 1094039 9388913 13772198 2384875 2440099 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406754 313729 2791629 2753828 X 6597284 11018370 0 0 0 0 6597284 11018370 9388913 13772198 4421086 X false true X true true true X false false false false false false false false true 1250 1250 false SCHEDULE C, PART II-B, LINE 1 OTHER 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, 2018 THE PORTION OF DUES PAID REPRESENTING LOBBYING EXPENDITURES WAS $1,250. 6222 6222 62911 2359 60552 3382950 823274 2559676 2923959 2156933 767026 90168 90168 3483644 DUE FROM AFFILIATE 727109 DUE FROM 3RD PARTY 366136 OTHER RECEIVABLES 794 1094039 0 DUE TO 3RD PARTY 212657 DUE TO AFFILIATE 101072 313729 34669507 -301425 -301425 34970932 -48936 -48936 34921996 30248421 48936 48936 30199485 301425 301425 30500910 SCHEDULE D, PART X, LINE 2 UNCERTAIN 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 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ (301,425) BAD DEBT EXPENSE SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ ( 33,060) RENTAL EXPENSES $ ( 15,876) LOSS ON DISPOSAL OF FIXED ASSETS ---------- $ ( 48,936) SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 33,060 RENTAL EXPENSES $ 15,876 LOSS ON DISPOSAL OF FIXED ASSETS ---------- $ 48,936 SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25 BUT NOT ON LINE 1: $ 301,425 BAD DEBT EXPENSE X X false false false false false false false true false FREDERICK JACKSON CEO 173805 0 14665 0 1187 0 10636 0 18936 0 219229 0 SEAN MCVEIGH PHYSICIAN 316746 0 1889 0 0 0 9400 0 20268 0 348303 0 RAYMOND RESNICK PHYSICIAN 549622 0 170106 0 0 0 16200 0 7397 0 743325 0 LOUIS C D'ORO PHYSICIAN 342935 0 12862 0 0 0 16200 0 20268 0 392265 0 DENISE VIOLA PHYSICIAN 193831 0 27105 0 0 0 11873 0 17605 0 250414 0 THOMAS O'BRIEN PHYSICIAN 212935 0 27106 0 0 0 13200 0 20268 0 273509 0 JOHN WEISENREIDER MEDICAL DIRECTOR 183835 0 1025 0 0 0 11268 0 17605 0 213733 0 MICHAEL CAMPBELL BEHAVIORAL DIRECTOR 226117 0 22606 0 0 0 13800 0 20268 0 282791 0 BRIAN BROWN DENTAL DIRECTOR 162270 0 91779 0 0 0 9900 0 20268 0 284217 0 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: BONUSES ARE BASED ON PRODUCTIVITY. MEDICAL PROVIDER BONUSES ARE BASED ON PATIENT ENCOUNTERS, WHILE DENTAL PROVIDER BONUSES ARE BASED ON A PERCENTAGE OF GROSS CHARGES LESS BASE SALARY. FORM 990, PART III, LINE 4A PROGRAM 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 4B PROGRAM 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 4C PROGRAM 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 4D OTHER 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 2 BUSINESS RELATIONSHIP: MICHAEL CLIFFORD AND DAVID HOFF SHARE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B 990 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 12C CONFLICT 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 THE CONFLICT OF INTEREST POLICY 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 & 15B COMPENSATION 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 THE FIRST QUARTER OF THE YEAR THE COMPENSATION CHANGE IS GRANTED. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND/OR FINANCIAL STATEMENTS AVAILABLE TO PUBLIC UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:1194644 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:2464180 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE CONTRACTS TOTAL FEES:194027