2024-05-14T15:37:09-05:00 2023-06-30 FORVIS LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2022-07-01 232180889 WAYNE MEMORIAL COMMUNITY HEALTH CENTERS % TERESA LACEY WAYN 5702516676 601 PARK STREET HONESDALE PA 18431 TERESA LACEY CEO 4178658701 2024-05-15 true TERESA LACEY XXX-XX-XXXX Krystal K Creach P01248198 4178658701 2024-05-15 3 2022 2023-04-26 12:10:37Z TERESA LACEY 601 PARK STREET HONESDALE PA 18431 50887561 false X WWW.WMH.ORG X 1981 PA WMCHC IS A PROGRESSIVE MULTI-SPECIALTY MEDICAL, DENTAL & BEHAVIORAL HEALTH GROUP SERVING NINE COMMUNITIES ACROSS FOUR COUNTIES IN NORTHESASTERN PENNSYLVANIA. 11 11 437 11 0 0 13196708 8852165 41396800 41578041 40463 357604 65321 28369 54699292 50816179 25000 25000 0 0 32189665 33315367 0 0 0 14310437 16011238 46525102 49351605 8174190 1464574 31427520 41164188 7688136 15527154 23739384 25637034 X SERVING ALL MEMBERS OF THE COMMUNITY WITH A FOCUS ON THE UNDERSERVED AND DISADVANTAGED, WAYNE MEMORIAL COMMUNITY HEALTH CENTERS WILL CREATE AND SUSTAIN A HEALTHY COMMUNITY BY PROVIDING ACCESSIBLE, HIGH QUALITY MEDICAL, DENTAL, AND BEHAVIORAL HEALTH CARE. false false 26066764 25000 27893960 WAYNE MEMORIAL COMMUNITY HEALTH CENTERS PROVIDES HIGH QUALITY PRIMARY CARE SERVICES THROUGH ITS FAMILY HEALTH CLINICS TO THE RESIDENTS IN THE COUNTIES OF WAYNE, PIKE, SOUTHERN SUSQUEHANNA AND THE CARBONDALE REGION OF UPPER LACKAWANNA COUNTY IN PENNSYLVANIA. WMCHC PROVIDES PRIMARY CARE IN THE TOWNS OF HONESDALE, HAMLIN, LAKE COMO, LORDS VALLEY, TAFTON, FOREST CITY, CARBONDALE AND WAYMART; AND PEDIATRIC CARE IN HONESDALE, CARBONDALE, WAYMART, STERLING AND LORDS VALLEY. 4813023 3403751 WMCHC PROVIDES WOMEN'S HEALTH CARE SERVICES THROUGH ITS WOMEN'S HEALTH CLINIC. THESE SERVICES INCLUDE OBSTETRICAL AND GYNECOLOGICAL SERVICES WITH BOARD CERTIFIED AND BOARD ELIGIBLE PHYSICIANS, CERTIFIED NURSE MIDWIVES, CRNP'S, ULTRASOUND TECHNOLOGISTS, AND REGISTERED NURSES IN HONESDALE, HAMLIN, DINGMANS FERRY AND CARBONDALE. 4350228 4494774 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. THE DENTAL PROGRAM ALSO PROVIDES DIRECT ON-SITE SERVICES TO VARIOUS MEDICAL SITES, HEAD START, YMCA, AND VARIOUS SCHOOLS IN THE SERVICE AREA. SEE SCHEDULE O FOR MORE INFORMATION. 7128845 5785556 42358860 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 true false true false false false false false false false false false false false false false false false false false true 58 0 true 437 true false false 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 TERESA LACEY 5702516676 601 PARK STREET HONESDALE PA 18431 ERIC RITTENHOUSE PHYSICIAN 40.0 0.0 X 382575 0 38419 ANGELA TANG PHYSICIAN 40.0 0.0 X 369656 0 38259 LOUIS D'ORO PHYSICIAN 40.0 0.0 X 342888 0 48657 TERRY LUMA PHYSICIAN 40.0 0.0 X 299929 0 18030 MICHAEL CAMPBELL BEHAVIORAL HEALTH DIRECTOR 40.0 0.0 X 288350 0 28277 BRIAN BROWN DENTAL CLINIC DIRECTOR 40.0 0.0 X 271077 0 29751 TUHIN GUPTA PHYSICIAN 40.0 0.0 X 277031 0 18300 FREDERICK JACKSON CEO END 02/23 40.0 0.0 X 218308 0 42045 JAMES CRUSE CHIEF MEDICAL OFFICER 40.0 0.0 X 216796 0 14959 ROBERT FORTUNER CFO 40.0 0.0 X 128708 0 17848 CARRIE DEMERS MD DIRECTOR 1.0 0.0 X 0 0 0 DAVID HOFF DIRECTOR 1.0 0.0 X 0 0 0 GREG CAPITOLO VICE CHAIR 1.0 0.0 X X 0 0 0 JAMES PETTINATO DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL CLIFFORD BOARD CHAIR 1.0 0.0 X X 0 0 0 MICHELLE WONDERS DIRECTOR 1.0 0.0 X 0 0 0 PATRICIA DUNSINGER TREASURER 1.0 0.0 X X 0 0 0 STEVE GUCCINI DIRECTOR 1.0 0.0 X 0 0 0 STEVE TOURJE DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM KERL DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM SCHWEIGHOFER BOARD SECRETARY 1.0 0.0 X X 0 0 0 WALTER SMITH DIRECTOR END 09/22 1.0 0.0 X 0 0 0 TERESA LACEY CEO BEG 02/23 40.0 0.0 X 0 0 0 2795318 0 294545 52 false true false AMERICAN COMP WEIGHT LOSS CENTER 603 HIGH STREET HONESDALE PA 18431 SURGICAL 416500 ALUMNI STAFFING LLC 1031 US HIGHWAY 22 STE 109 BRIDGEWATER NJ 08807 LOCUM TENENS 294303 BRANNING CLEANING SERVICES 26 ARROW LANE WAYMART PA 18472 CLEANING 279928 JENNIFER LAUREN RODRIGUEZ AIELLO 6822 GLENCOVE DRIVE CLIFTON VA 20124 SURGICAL 211284 LOCUM TENENS HOLDINGS LLC 2655 NORTHWINDS PARKWAY ATLANTA GA 30009 RECRUITING 206843 6 4919288 3932877 8852165 NET PATIENT SERVICE REVENUE 621110 40548836 40548836 CAPITATION REVENUE 900099 806047 806047 CLINICAL CONTRACT REVENUE 621110 200022 200022 OTHER INCOME 900099 23136 23136 41578041 358716 358716 0 0 98639 70270 28369 0 28369 28369 0 1112 -1112 -1112 -1112 0 0 0 0 0 0 0 0 0 0 50816179 41578041 385973 X 25000 25000 0 0 0 1256119 849210 406909 0 25172320 22664701 2507619 1038760 914917 123843 4109845 3526912 582933 1738323 1531629 206694 500000 500000 161823 161823 65532 65532 0 0 0 5894911 4583214 1311697 27984 21127 6857 3963377 3448876 514501 0 0 1675830 1545325 130505 105538 89219 16319 0 78427 36100 42327 32996 32996 0 836834 740752 96082 428224 201556 226668 0 MEDICAL SUPPLIES & DRUGS 2056295 2056295 LICENSES, DUES, SUBSCRIPTIONS 146064 110752 35312 REPAIRS & MAINTENANCE 37403 13275 24128 49351605 42358860 6992745 0 4682907 2001517 12797613 7700260 1017394 1376668 2825904 3147632 0 0 0 0 0 0 0 0 754958 819486 14792374 5947688 7610330 8844686 0 5452823 0 0 0 0 322500 207500 1415914 11613616 31427520 41164188 4440400 4506883 0 0 571952 20000 0 0 0 0 0 0 1035134 0 0 0 1640650 11000271 7688136 15527154 X 23739384 25637034 0 0 23739384 25637034 31427520 41164188 1464574 433076 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1250 1250 false SCHEDULE C, PART II-B, LINE 1(I) 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, 2023 THE PORTION OF DUES PAID REPRESENTING LOBBYING EXPENDITURES WAS $1,250. 494954 494954 2848559 388418 2460141 7104947 2353501 4751446 3772826 3075184 697642 571088 130585 440503 8844686 DUE FROM 3RD PARTY 571604 OTHER RECEIVABLES 2093 DUE FROM AFFILIATE 400871 SELF INSURANCE RESERVE 153954 ROU ASSET 10485094 11613616 0 DUE TO AFFILIATE 241 DUE TO 3RD PARTY 190418 ACCRUED SELF INSURANCE 324518 LEASE LIABILITY 10485094 11000271 51319525 433076 433076 50886449 -70270 -70270 50816179 49421875 70270 70270 49351605 49351605 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 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (70,270) RENTAL EXPENSES SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART XI, LINE 25: $ 70,270 RENTAL EXPENSES true WAYNE MEMORIAL HOSPITAL 601 PARK STREET HONESDALE PA 18431 240798839 501(C)(3) 25000 FOOD RX PROGRAM 1 SCHEDULE I, PART I, LINE 2 GRANT MONITORING PROCEDURES: GRANT EXPENDITURES ARE TRACKED BY THE ORGANIZATION'S ACCOUNTING STAFF TO DETERMINE COMPLIANCE WITH GRANT PROGRAMS AND REPORTED TO THE BOARD OF TRUSTEES. X X false false false false false false false false false FREDERICK JACKSON CEO END 02/23 218308 0 0 0 0 0 15098 0 26947 0 260353 0 0 0 BRIAN BROWN DENTAL CLINIC DIRECTOR 271077 0 0 0 0 0 17424 0 12327 0 300828 0 0 0 JAMES CRUSE CHIEF MEDICAL OFFICER 216796 0 0 0 0 0 14959 0 0 0 231755 0 0 0 MICHAEL CAMPBELL BEHAVIORAL HEALTH DIRECTOR 288350 0 0 0 0 0 18300 0 9977 0 316627 0 0 0 ANGELA TANG PHYSICIAN 369656 0 0 0 0 0 9150 0 29109 0 407915 0 0 0 ERIC RITTENHOUSE PHYSICIAN 382575 0 0 0 0 0 18300 0 20119 0 420994 0 0 0 LOUIS D'ORO PHYSICIAN 342888 0 0 0 0 0 18300 0 30357 0 391545 0 0 0 TERRY LUMA PHYSICIAN 299929 0 0 0 0 0 18030 0 0 0 317959 0 0 0 TUHIN GUPTA PHYSICIAN 277031 0 0 0 0 0 18300 0 0 0 295331 0 0 0 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 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 4C PROGRAM SERVICE ACTIVITY #3: 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 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: PATRICIA DUNSINGER AND JAMES PETTINATO 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 IS 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, LINES 15A & 15B COMPENSATION REVIEW: WAYNE MEMORIAL COMMUNITY HEALTH CENTERS UTILIZES 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:PURCHASED SERVICES TOTAL FEES:3862625 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:1261439 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE CONTRACTS TOTAL FEES:770847