2024-11-25T16:26:13-06:00 2024-06-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2023-07-01 931250581 WATERFALL CLINIC INC WATE 5417566232 1890 WAITE STREET 1 NORTH BEND OR 97459 LANCE NELSON CEO 5417566232 2024-11-21 1 0 KURT BENNION CPA P01469618 4252506100 2024-11-21 2023 2024-10-15 13:58:12Z WATERFALL COMMUNITY HEALTH CENTER LANCE NELSON 1890 WAITE STREET 1 NORTH BEND OR 97459 17213049 0 X WWW.WFALL.ORG X 1998 OR TO PROMOTE ACCESS TO QUALITY INTEGRATED HEALTH SERVICES THAT MEET THE NEEDS OF INDIVIDUALS WITH BARRIERS TO CARE ON THE SOUTHERN OREGON COAST. 10 10 140 12 -16640 0 3459229 3654745 8185206 13448932 -170008 18705 107447 -10871 11581874 17111511 0 18490 0 0 8213376 10414844 0 0 0 2814463 3263597 11027839 13696931 554035 3414580 10896364 17059547 4885485 7634088 6010879 9425459 TO PROMOTE ACCESS TO QUALITY INTEGRATED HEALTH SERVICES THAT MEET THE NEEDS OF INDIVIDUALS WITH BARRIERS TO CARE ON THE SOUTHERN OREGON COAST. 0 0 10412495 18490 13448932 THE ORGANIZATION PROVIDED INTEGRATED HEALTH CARE SERVICES TO INDIVIDUALS WITH BARRIERS TO CARE ON THE SOUTHERN OREGON COAST. SERVICES INCLUDE MEDICAL, DENTAL, MENTAL HEALTH CARE, PSYCHIATRY AND AUTISM SERVICES. 10412495 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 13 0 140 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 1 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 OR X ANDREA ZAMORA 5417566232 1890 WAITE STREET 1 NORTH BEND OR 97459 LORRAINE DAVIES MD PSYCHIATRIST 40.00 X 396573 0 45478 ROBERT GERBER MD PHYSICIAN 40.00 X 289875 0 1303 LANCE NELSON MS LPC CHIEF EXECUTIVE OFFICER 40.00 X 222824 0 3969 ANDREA ZAMORA CPA CHIEF FINANCIAL OFFICER 40.00 X 198733 0 15839 ANTONIA PEREZ FNP PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER 40.00 X 168865 0 11974 DR PRIYA AGRAWAL DENTAL PROGRAM MANAGER 40.00 X 157418 0 8179 MARK PASTERNAK MD PHYSICIAN 40.00 X 144117 0 9310 CRAIG WRIGHT CHIEF MEDICAL OFFICER 40.00 X 138532 0 8312 NICOLE NORRIS MA THW CHIEF QUALITY OFFICER 40.00 X 129254 0 9139 KAREN SHEELAR MS LPC NCC CHIEF BEHAVIORAL HEALTH OFFICER 40.00 X 131699 0 4921 JUSTIN CASEY CHIEF OPERATING OFFICER 40.00 X 126321 0 5670 SANDRA QUALMAN PRESIDENT 1.00 X X 0 0 0 MARCE KNIGHT VICE PRESIDENT 1.00 X X 0 0 0 ELIZABETH BRIGHAM SECRETARY 1.00 X X 0 0 0 TONY CRANE TREASURER 1.00 X X 0 0 0 MCLCAIN ALTMAN DIRECTOR 1.00 X 0 0 0 RUTH BELL DIRECTOR 1.00 X 0 0 0 ANNA HUIT DIRECTOR 1.00 X 0 0 0 ARNOLD ROBLAN DIRECTOR 1.00 X 0 0 0 LESLIE RYAN DIRECTOR 1.00 X 0 0 0 STEVE SANDEN DIRECTOR 1.00 X 0 0 0 2104211 0 124094 17 0 1 0 OCHIN 1881 SW NAITO PARKWAY PORTLAND OR 97201 ELECTRONIC MEDICAL RECORDS SERVICES 246243 CURATIVE TALENT 370 W LAS COLINAS BLVD SUITE 104 IRVING TX 75039 STAFFING SERVICES 109800 CENTERLOGIC 7414 NE HAZEL DELL AVENUE 150 VANCOUVER WA 98665 IT CONTRACT SERVICES 101631 3 3514740 140005 3654745 PATIENT SERVICES 624100 7533950 7533950 CAPITATION 624100 5062577 5062577 OTHER PROGRAM REVENUES 624100 449758 449758 PHARMACY 456110 402647 402647 13448932 18705 18705 90582 101538 -10956 -10956 -16640 5684 MISCELLANEOUS INCOME 900099 85 85 85 17111511 13448932 -16640 24474 10000 10000 8490 8490 988516 988516 7206886 6115686 1091200 311762 249174 62588 1017863 778580 239283 889817 667363 222454 69695 69695 1138886 897871 241015 64424 64424 101100 75825 25275 383013 341955 41058 44886 38999 5887 158039 158039 291633 218725 72908 106848 80136 26712 SUPPLIES 438243 342697 95546 OTHER EMPLOYEE EXPENSES 157613 118907 38706 PROGRAM DEVELOPMENT 114789 99523 15266 DUES & SUBSCRIPTIONS 80091 60069 20022 114337 86032 28305 13696931 10412495 3284436 0 816209 2356935 788050 1488485 1389211 2454582 73301 98669 11320387 1714269 4015337 9606118 3814256 1054758 10896364 17059547 454601 718916 59771 13654 564290 5761344 3866594 1080403 4885485 7634088 X 6010879 9392959 32500 6010879 9425459 10896364 17059547 3414580 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 622538 622538 9474382 1141367 8333015 538652 52603 486049 684815 520299 164516 9606118 SECURITY DEPOSITS 12575 RIGHT-OF-USE LEASE ASSETS 1042183 1054758 RIGHT-OF-USE LEASE LIABILITIES 1080403 1080403 X 17180549 101538 101538 17079011 32500 32500 17111511 13798469 101538 101538 13696931 0 13696931 PART IV, LINE 2B: THE ORGANIZATION HOLDS SECURITY DEPOSITS FOR RENTAL TENANTS. THE FUNDS ARE RETURNED TO THE TENANT WHEN THE RENTAL RELATIONSHIP ENDS, LESS THE COST OF ANY REPAIRS. PART X, LINE 2: THE CENTER IS INCORPORATED AS A NONPROFIT ENTITY AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAX UNDER THE PROVISIONS OF THE INTERNAL REVENUE CODE SECTION 501(C)(3). MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT, AS OF JUNE 30, 2024 AND 2023, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2021 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW, AND NEW AUTHORITATIVE RULINGS. THE CENTER WILL RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENT OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 101,538. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS WITH DONOR RESTRICTIONS 32,500. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 101,538. 1 COOS BAY COAST LEAGUE PO BOX 56 COOS BAY OR 97420 264374145 501(C)(3) 10000 0 GENERAL OPERATING SUPPORT 1 0 TRANSPORTATION ASSISTANCE 455 5660 CLOTHING ASSISTANCE 91 1132 HOUSING ASSISTANCE 137 1698 PART I, LINE 2: PRIOR TO GIVING TO ANOTHER ORGANIZATION, WATERFALL CLINIC CONFIRMS THEIR CHARITABLE OR GOVERNMENTAL STATUS. GRANTS ARE INTENDED AS GENERAL OPERATING SUPPORT, SO NO FURTHER FOLLOW-UP IS CONDUCTED. CASH IS NOT GIVEN DIRECTLY TO INDIVIDUALS. ANY PAYMENTS ARE MADE DIRECTLY TO THIRD PARTIES ON THE INDIVIDUAL'S BEHALF. INDIVIDUALS ARE GIVEN GAS CARDS THAT HAVE TO BE USED AT THE GASH STATION. X 0 0 0 0 0 0 0 0 0 LORRAINE DAVIES MD PSYCHIATRIST 353302 0 10088 0 33183 0 21700 0 23778 0 442051 0 0 0 ROBERT GERBER MD PHYSICIAN 272715 0 13560 0 3600 0 0 0 1303 0 291178 0 0 0 LANCE NELSON MS LPC CHIEF EXECUTIVE OFFICER 214924 0 7900 0 0 0 1270 0 2699 0 226793 0 0 0 ANDREA ZAMORA CPA CHIEF FINANCIAL OFFICER 193588 0 5145 0 0 0 1696 0 14143 0 214572 0 0 0 ANTONIA PEREZ FNP PSYCHIATRIC MENTAL HEALTH NURSE PRAC 156307 0 12558 0 0 0 9117 0 2857 0 180839 0 0 0 DR PRIYA AGRAWAL DENTAL PROGRAM MANAGER 125212 0 10000 0 22206 0 7633 0 546 0 165597 0 0 0 MARK PASTERNAK MD PHYSICIAN 141364 0 2753 0 0 0 8647 0 663 0 153427 0 0 0 FORM 990, PART VI, SECTION A, LINE 1A THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE OFFICERS OF THE BOARD. TO THE EXTENT PERMITTED BY LAW AND BY THE RESOLUTION OF THE BOARD, THE EXECUTIVE COMMITTEE MAY EXERCISE ALL OF THE AUTHORITY OF THE BOARD EXCEPT (A) THE AMENDMENT OR REPEAL OF ANY BOARD RESOLUTION, (B) ENCUMBERING FINANCIAL OBLIGATIONS ON BEHALF OF THE BOARD OR THE ORGANIZATOIN, (C) THE APPOINTMENT OF ANY COMMITTEES OR MEMBERS OF ANY COMMITTEES, AND (D) APPROVAL OR REMOVAL OF BOARD MEMBERS. THROUGH MAY 2024, THE EXECUTIVE COMMITTEE HAD THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS WHEN THE FULL BOARD WAS NOT AVAILABLE AND IMMEDIATE ACTION WAS NECESSARY. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED IN MAY 2024 TO CLARIFY THAT THE CEO IS A NON-VOTING EX-OFFICIO MEMBER OF THE BOARD OF DIRECTORS AND TO REMOVE THE EXECUTIVE COMMITTEE'S AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS WHEN THE FULL BOARD IS NOT AVAILABLE AND IMMEDIATE ACTION IS NECESSARY. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 WAS REVIEWED BY THE CFO AND THE CEO, THEN IT WAS PROVIDED TO THE FINANCE COMMITTEE FOR REVIEW, AFTER WHICH IT RECOMMENDED THAT THE BOARD APPROVE TO FILE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO THE BOARD MEMBERS, OFFICERS AND EXECUTIVE MANAGEMENT EMPLOYEES. EACH COVERED INDIVIDUAL IS REQUIRED TO COMPLETE A DISCLOSURE STATEMENT ON AN ANNUAL BASIS. EMPLOYEES DISCLOSE CONFLICTS OF INTEREST TO THE CEO. BOARD MEMBERS DISCLOSE CONFLICTS OF INTEREST TO THE BOARD PRESIDENT. IF IT IS UNCLEAR WHETHER A CONFLICT EXISTS, THE BOARD OF DIRECTORS MAKES THE DETERMINATION. THE BOARD OF DIRECTORS DETERMINES WHETHER THE TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR AND REASONABLE TO THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15A A BOARD SUB-COMMITTEE PERFORMS A REVIEW OF THE CEO AND MAKES A RECOMMENDATION TO THE BOARD REGARDING COMPENSATION UTILIZING SALARY SURVEY DATA PROVIDED BY NORTHWEST REGIONAL PRIMARY CARE ASSOCIATION AND THE OREGON PRIMARY CARE ASSOCIATION. THE CEO PERFORMS REVIEWS OF OTHER OFFICERS AND KEY EMPLOYEES AND UTILIZES THE SALARY SURVEY DATA PROVIDED BY NORTHWEST REGIONAL PRIMARY CARE ASSOCIATION AND THE OREGON PRIMARY CARE ASSOCIATION TO DETERMINE COMPENSATION. THIS PROCESS IS COMPLETED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 ANY MEMBER OF THE PUBLIC MAY REVIEW THE GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS IN THE BUSINESS OFFICE DURING NORMAL BUSINESS HOURS.