2023-05-15T16:11:04-05:00 2022-06-30 930743240 HOFFMAN STEWART & SCHMIDT PC 3 CENTERPOINTE DRIVE SUITE 300 LAKE OSWEGO OR 970358663 990 2021-07-01 930853709 THE WALLACE MEDICAL CONCERN WALL 5034891760 18633 SE STARK STREET 401 PORTLAND OR 97233 LISA CLINE CEO 5034891760 2023-05-11 1 LISA CLINE 999009999 JENNIFER A PERRIER P01321794 5032205900 0 AAL1 IAL1 2021 2023-04-26 12:10:37Z LISA CLINE 18633 SE STARK STREET 401 PORTLAND OR 97233 9791449 0 X WWW.MYWALLACE.ORG X 1984 OR PROVIDE HEALTH SERVICES TO THOSE IN NEED IN THE PORTLAND AND GRESHAM METROPOLITAN AREA. 8 8 104 10 0 0 5632191 4078027 4848581 5523786 4542 4528 328585 185108 10813899 9791449 41673 6793 0 0 5353047 6250589 9007 0 200312 2981639 3765051 8385366 10022433 2428533 -230984 7288322 7319360 1934306 2213568 5354016 5105792 X THE WALLACE MEDICAL CONCERN ("WMC") PROVIDES AN OPEN DOOR TO EXCEPTIONAL SERVICES THAT SUPPORT INDIVIDUALS AND THEIR FAMILIES IN HEALTHY LIVING. WMC SERVES INDIVIDUALS AND FAMILIES WHO FACE BARRIERS TO CARE THROUGHOUT THE PORTLAND AND GRESHAM METROPOLITAN AREA. 0 0 7418369 6793 5708894 THE WALLACE MEDICAL CONCERN (WALLACE) PROVIDES AN OPEN DOOR TO EXCEPTIONAL HEALTH SERVICES AND CONNECTIONS THAT SUPPORT INDIVIDUALS AND THEIR FAMILIES IN HEALTHY LIVING. WALLACE HAS A 35 YEAR RECORD OF PROVIDING MEDICAL SERVICES AND HAS DISTINGUISHED ITSELF AS A PATIENT CENTERED,INNOVATIVE HEALTH CARE ORGANIZATION. WALLACE BECAME A FEDERALLY QUALIFIED HEALTH CENTER IN JUNE OF 2012, ALLOWING FOR EXPANDED SERVICES AND IMPLEMENTATION OF PRIMARY CARE THAT OFFERS A COMPREHENSIVE MEDICAL HOME AND CONTINUITY OF CARE FOR PATIENTS AND THEIR FAMILIES. WE OFFER INTEGRATED MEDICAL, DENTAL, AND BEHAVIORAL/ MENTAL HEALTH SERVICES. MEDICAL SERVICES INCLUDE PEDIATRIC CARE, WOMEN'S HEALTH, AND CHRONIC DISEASE MANAGEMENT. OUR CARE TEAMS ADDRESS SOCIAL DETERMINANTS OF HEALTH SUCH AS FOOD SECURITY AND HOUSING.WALLACE'S INCREASING CAPACITY TO PROVIDE HIGH QUALITY HEALTH SERVICES IS DUE TO ITS SUCCESS IN ATTRACTING SKILLED AND COMMITTED MEDICAL PROFESSIONALS, ITS INNOVATIVE PARTNERSHIPS, AND ITS MULTICULTURAL,MULTILINGUAL STAFF. 7418369 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 1 104 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 OR X X BILL MITBERG 5034891760 18633 SE STARK STREET SUITE 400 PORTLAND OR 97233 LYNN KETCH PRESIDENT 1.00 X X 0 0 0 JOHN ENGLE SECRETARY 1.00 X X 0 0 0 EDITH ARRIAGA-FLORES VICE PRESIDENT 1.00 X X 0 0 0 ANDREW BROWN TREASURER 1.00 X X 0 0 0 JAKE OHMAN DIRECTOR 1.00 X 0 0 0 MARK HESS DIRECTOR 1.00 X 0 0 0 MOLLY ROBERTS DIRECTOR 1.00 X 0 0 0 EMANUEL BARERRA DIRECTOR 1.00 X 0 0 0 VANESSA CHAMBERS DIRECTOR 1.00 X 0 0 0 RHONDA COMBS DIRECTOR 1.00 X 0 0 0 STUART CURRIE MD CMO 40.00 X 317082 0 21155 LISA CLINE CEO 40.00 X 190221 0 5766 AMY BRISSON CONTRACTED CFO 18.00 X 110417 0 0 KYLE GEELAN DMD DENTAL DIRECTOR 40.00 X 180778 0 5806 BRITTA MARTINEZ ASSISTANT DENTAL DIRECTOR 40.00 X 156114 0 9582 APRIL URQUIDEZ MENTAL HEALTH NP 40.00 X 149647 0 10675 LORI-ANN LIMA FAMILY NP 40.00 X 131272 0 7888 BETHANY STAIRS ASSISTANT MEDICAL DIRECTOR 40.00 X 126684 0 13682 MARY CAITLYN WELLS FAMILY NP 40.00 X 125521 0 6576 1487736 0 81130 9 0 1 0 CENTRAL BETHANY DEVELOPMENT CO LP 15160 NW LAIDLAW RD SUITE 103 PORTLAND OR 97229 DEVELOPMENT OF ROCKWOOD CLINIC 389062 OCHIN PO BOX 5426 PORTLAND OR 97228 IT AND PATIENT BILLING SERVICES 255019 LIFEWORKS NORTHWEST 5415 SW WESTGATE DR PORTLAND OR 97221 CONTRACTED MEDICAL AND MENTAL HEALTH CAR 229257 LIGHTPOINT PO BOX 5966 PORTLAND OR 97228 IT SERVICES AND EQUIPMENT 215409 ROCKWOOD MSC QALICB INC 18173 NE COUCH ST PORTLAND OR 97230 RENTS PAID FOR ROSEWOOD CLINIC 150776 7 3835026 243001 4078027 WRAP AROUND AND PREMIU 621110 2864518 2864518 PATIENT SERVICE FEES 621110 1703430 1703430 CCCO INCENTIVE 621110 914073 914073 PHARMACY REVENUE 621110 41765 41765 5523786 4248 4248 20576 0 20576 20576 20576 280 0 280 280 280 OTHER REVENUE 900099 164532 164532 164532 9791449 5708894 0 4528 X 6793 6793 567509 419957 136202 11350 4695744 3474850 1126979 93915 139402 103158 33456 2788 465897 344764 111815 9318 382037 282707 91689 7641 11064 8188 2655 221 35650 26381 8556 713 1104212 817117 265011 22084 70606 52249 16945 1412 120209 88955 28850 2404 915458 677439 219710 18309 23524 17408 5646 470 46027 34060 11046 921 383970 284138 92153 7679 51605 38188 12385 1032 SUPPLIES 529870 392104 127169 10597 EQUIPMENT 213484 157978 51236 4270 JANITORIAL 79421 58772 19061 1588 DUES 56784 42020 13628 1136 123167 91143 29560 2464 10022433 7418369 2403752 200312 718830 1829882 1871624 1871988 1326431 70086 428033 857726 183706 186363 3717583 1214268 2759698 2503315 7288322 7319360 177507 534645 493194 746634 1263605 932289 1934306 2213568 X 4915173 5105792 438843 0 5354016 5105792 7288322 7319360 -230984 -17240 0 X X 0 0 0 X 2931945 2669341 2899925 5632191 4078027 18211429 2931945 2669341 2899925 5632191 4078027 18211429 18211429 605 1536 11861 12600 24824 51426 222778 121759 183446 321782 164532 1014297 19277152 0.94470 0.94370 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2789290 638143 2151147 842371 576125 266246 85922 85922 2503315 X PART X, LINE 2: WMC IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND COMPARABLE STATE LAW. IN ADDITION, WMC HAS BEEN RECOGNIZED AS A PUBLIC CHARITY UNDER SECTIONS 170(B)(1)(A)(VI) AND 509(A)(1) OF THE IRC. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED WMC'S TAX POSITIONS AND CONCLUDED THAT WMC HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740. 1 PATIENT AND NON-MEDICAL FINANCIAL ASSISTANCE 76 2659 0 PATIENT HOUSING ASSISTANCE 4 3898 0 OTHER 1 236 PART I, LINE 2: FINANCIAL ASSISTANCE IS RECOMMENDED AND REQUESTED BY THE WALLACE MEDICAL CONCERN EMPLOYEE ON BEHALF OF A PATIENT WHEN THE EMPLOYEE SEES A NEED. PAYMENTS ARE MADE DIRECTLY TO THIRD PARTIES TO ASSIST PATIENTS, ENSURING THAT ALL FUND ARE USED FOR THE INTENDED PURPOSE. X X 0 0 0 0 0 0 0 0 0 STUART CURRIE MD CMO 317082 0 0 0 0 0 21155 0 0 0 338237 0 0 0 LISA CLINE CEO 190221 0 0 0 0 0 5766 0 0 0 195987 0 0 0 KYLE GEELAN DMD DENTAL DIRECTOR 180778 0 0 0 0 0 5806 0 0 0 186584 0 0 0 BRITTA MARTINEZ ASSISTANT DENTAL DIRECTOR 156114 0 0 0 0 0 9582 0 0 0 165696 0 0 0 APRIL URQUIDEZ MENTAL HEALTH NP 149647 0 0 0 0 0 10675 0 0 0 160322 0 0 0 FORM 990, PART IV, SECTION A, LINE 1: THE OFFICERS OF THE BOARD OF DIRECTORS AND ONE ADDITIONAL DIRECTOR SERVE AS THE MEMBERS OF THE EXECUTIVE COMMITTEE. THE CEO SITS ON THE EXECUTIVE COMMITTEE AS AN ADVISOR, BUT DOES NOT HAVE A VOTE. THE EXECUTIVE COMMITTEE HAS ALL OF THE POWERS AND AUTHORITY OF THE BOARD OF DIRECTORS WHEN ACTING IN A REASONABLE MANNER DURING AN EMERGENCY AS DELEGATED BY THE BOARD, IF IT IS IMPRACTICAL TO CONVENE A MEETING OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY MANAGEMENT. A COPY OF THE FORM 990 WILL BE PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER, AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD-DELEGATED POWERS IS REQUIRED TO SIGN AND SUBMIT A CONFLICT OF INTEREST DISCLOSURE STATEMENT FOR CONSIDERATION BY THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD-DELEGATED POWERS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, THIS INTERESTED PERSON IS REQUIRED TO LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POTENTIAL CONFLICT. IN ADDITION, A PERIODIC REVIEW IS PERFORMED BY THE GOVERNING BOARD AND, AT A MINIMUM, INCLUDES WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. FORM 990, PART VI, SECTION B, LINE 15A THE SALARY OF THE CHIEF EXECUTIVE OFFICER IS DETERMINED BY THE BOARD OF DIRECTORS AFTER A REVIEW OF THE NON-PROFIT AND HEALTH CENTER SALARY SURVEY FOR THE REGION. THIS PROCESS WAS LAST COMPLETED IN 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED EMPLOYEES: PROGRAM SERVICE EXPENSES 817,117. MANAGEMENT AND GENERAL EXPENSES 265,011. FUNDRAISING EXPENSES 22,084. TOTAL EXPENSES 1,104,212.