ST MARYS HEALTH WAGON: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS HEALTH WAGON (EIN 04-3739083)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-13
- IRS object ID
- 202223179349301407
- Schema version
- 2021v4.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-13T07:22:29-08:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 541283622 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Larry D Sturgill CPA PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2080 | AddressLine1Txt |
| City | WISE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24293 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 043739083 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARYS HEALTH WAGON INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 2763288850 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 7070 | AddressLine1Txt |
| City | WISE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24293 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERESA TYSON | PersonNm |
| Person Title | President & CEO | PersonTitleTxt |
| Signature | 2022-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TERESA | PersonFirstNm |
| Person Last | TYSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LARRY D STURGILL | PreparerPersonNm |
| PTIN | P00381273 | PTIN |
| Phone | 2763289593 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 7070 | AddressLine1Txt |
| City | WISE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24293 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,015,564 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | THEHEALTHWAGON.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | The Health Wagon serves as the oldest free mobile clinic in the nation and embraces a mission that "provides compassionate, quality health care to the medically underserved people" in the impoverished mountains of Central Appalachia. The Health Wagon champions the values of inclusiveness, community outreach, collaboration, spirituality, and empowerment. It is a free nurse-managed health clinic consisting of two stationary and four mobile clinics. The Health Wagon serves as the only dedicated safety net for those living in the farthest part of southwest Virginia. The clinics leadership in the healthcare sector has garnered notable recognition including interviews in media that include 60 Minutes, Nightline, CBS Nightly News, Inside Edition, Washington Post and the New York Times along with other extensive media attention regarding efforts to provide access to health care to the poor and marginalized population in the Appalachian region. The Health Wagon is a recognized leader in health | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 71 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $5,305,902 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,074,464 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $101,225 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $53,486 | CYProgramServiceRevenueAmt |
| PY Investment Income | $635,307 | PYInvestmentIncomeAmt |
| CY Investment Income | $887,614 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $6,042,434 | PYTotalRevenueAmt |
| CY Total Revenue | $10,015,564 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,589,094 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,929,463 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $33,600 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $22,800 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $346,727 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,668,766 | PYOtherExpensesAmt |
| CY Other Expenses | $1,737,445 | CYOtherExpensesAmt |
| PY Total Expenses | $4,291,460 | PYTotalExpensesAmt |
| CY Total Expenses | $5,689,708 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,750,974 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,325,856 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,715,123 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,771,521 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $497,042 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $227,584 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,218,081 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,543,937 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The Health Wagon serves as the oldest free mobile clinic in the nation and embraces a mission that "provides compassionate, quality health care to the medically underserved people" in the impoverished mountains of Central Appalachia. The Health Wagon champions the values of inclusiveness, community outreach, collaboration, spirituality, and empowerment. It is a free nurse-managed health clinic consisting of two stationary and four mobile clinics. The Health Wagon serves as the only dedicated safety net for those living in the farthest part of southwest Virginia. The clinics leadership in the healthcare sector has garnered notable recognition including interviews in media that include 60 Minutes, Nightline, CBS Nightly News, Inside Edition, Washington Post and the New York Times along with other extensive media attention regarding efforts to provide access to health care to the poor and marginalized population in the Appalachian region. The Health Wagon is a recognized leader in health | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,013,749 | ExpenseAmt |
| Desc | ** See Schedule O ** | Desc |
| Total Program Service Expenses | $5,013,749 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | Yes (true) | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (true) | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 71 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERESA TYSON | PersonNm |
| Phone | 2763288850 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5626 PATRIOT DRIVE | AddressLine1Txt |
| City | WISE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24293 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| TERESA TYSON | |||||||
| PRESIDENT & CEO | 40.00 | 20.00 | $269,292 | $70,655 | $0 | ||
| RACHEL HELTON | |||||||
| Grant Manager | 40.00 | 0.00 | $244,812 | $0 | $0 | ||
| PAULA HILL-COLLINS | |||||||
| Clinical Director | 40.00 | 0.00 | $221,590 | $0 | $0 | ||
| ETHAN T COLLINS | |||||||
| NURSE PRACTIONER | 40.00 | 0.00 | $190,614 | $0 | $0 | ||
| OLIVIA STALLARD | |||||||
| DENTIST | 40.00 | 0.00 | $160,872 | $0 | $0 | ||
| ROSS B ISAACS | |||||||
| PHYSICIAN | 40.00 | 0.00 | $160,400 | $0 | $0 | ||
| BENJAMIN A CAREY | |||||||
| PSYCHIATRIST | 40.00 | 0.00 | $157,655 | $0 | $0 | ||
| CARA N ROBINSON | |||||||
| NURSE PRACTIONER | 40.00 | 0.00 | $132,418 | $0 | $0 | ||
| DR ROSS ISAACS MD | |||||||
| Director | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| TONY GREENE | |||||||
| Director | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| CHARLES KISER | |||||||
| Director | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| PATRICIA SONNER | |||||||
| Secretary | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) |
| STEVE SMITH | |||||||
| Director | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| SHEILA COLLINS | |||||||
| Director | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| MARY WHITE | |||||||
| Director | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| DR JOSEPH F SMIDDY | |||||||
| Chairman | 8.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| TERESA TYSON | |||||||
| President & CEO | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,537,653 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $70,655 | TotReportableCompRltdOrgAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,173,225 | GovernmentGrantsAmt |
| All Other Contributions | $6,901,239 | AllOtherContributionsAmt |
| Noncash Contributions | $179,413 | NoncashContributionsAmt |
| Total Contributions | $9,074,464 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL FEE'S | Desc |
| Total Revenue Column | $53,486 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $53,486 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $53,486 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $887,614 | TotalRevenueColumnAmt |
| Exclusion | $887,614 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,015,564 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $53,486 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $887,614 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,405,235 | TotalAmt |
| Program Services | $1,405,235 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,874,788 | TotalAmt |
| Program Services | $1,505,508 | ProgramServicesAmt |
| Management And General | $164,001 | ManagementAndGeneralAmt |
| Fundraising | $205,279 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $411,526 | TotalAmt |
| Program Services | $353,911 | ProgramServicesAmt |
| Management And General | $20,577 | ManagementAndGeneralAmt |
| Fundraising | $37,038 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $237,914 | TotalAmt |
| Program Services | $204,605 | ProgramServicesAmt |
| Management And General | $11,897 | ManagementAndGeneralAmt |
| Fundraising | $21,412 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,485 | TotalAmt |
| Program Services | $66,010 | ProgramServicesAmt |
| Management And General | $3,475 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,800 | TotalAmt |
| Fundraising | $22,800 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,305 | TotalAmt |
| Management And General | $88,305 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,150 | TotalAmt |
| Program Services | $19,144 | ProgramServicesAmt |
| Management And General | $1,006 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,201 | TotalAmt |
| Fundraising | $4,201 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,777 | TotalAmt |
| Program Services | $59,639 | ProgramServicesAmt |
| Management And General | $3,138 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $229,747 | TotalAmt |
| Program Services | $218,260 | ProgramServicesAmt |
| Management And General | $11,487 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,293 | TotalAmt |
| Program Services | $43,029 | ProgramServicesAmt |
| Management And General | $2,264 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,964 | TotalAmt |
| Program Services | $167,166 | ProgramServicesAmt |
| Management And General | $8,798 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,128 | TotalAmt |
| Program Services | $74,222 | ProgramServicesAmt |
| Management And General | $3,906 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT SERVICE EXPENSE | $333,369 | $333,369 | |
| CONSULTING SERVICES | $289,844 | $289,844 | |
| UTILITIES | $72,554 | $68,927 | $3,627 |
| LICENSE | $56,439 | $53,618 | $2,821 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,189 | TotalAmt |
| Program Services | $151,262 | ProgramServicesAmt |
| Management And General | $3,930 | ManagementAndGeneralAmt |
| Fundraising | $55,997 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,689,708 | TotalAmt |
| Program Services | $5,013,749 | ProgramServicesAmt |
| Management And General | $329,232 | ManagementAndGeneralAmt |
| Fundraising | $346,727 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,599,792 | BOYAmt |
| EOY | $3,077,590 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $225,173 | BOYAmt |
| EOY | $277,484 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,189,441 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $689,495 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,420,066 | BOYAmt |
| EOY | $3,499,946 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,125,508 | BOYAmt |
| EOY | $8,525,313 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $344,584 | BOYAmt |
| EOY | $391,188 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,715,123 | BOYAmt |
| EOY | $15,771,521 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,803 | BOYAmt |
| EOY | $60,586 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $476,239 | BOYAmt |
| EOY | $166,998 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $497,042 | BOYAmt |
| EOY | $227,584 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,537,189 | BOYAmt |
| EOY | $13,728,669 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $680,892 | BOYAmt |
| EOY | $1,815,268 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,218,081 | BOYAmt |
| EOY | $15,543,937 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,715,123 | BOYAmt |
| EOY | $15,771,521 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,325,856 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Donor Advised Funds Held | 1 | DonorAdvisedFundsHeldCnt |
| Donor Advised Funds Vl EOY | $124,000 | DonorAdvisedFundsVlEOYAmt |
| Disclosed Org Leg Ctrl | false | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | false | DisclosedForCharitablePrpsInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $93,000 | InvestmentCostOrOtherBasisAmt |
| Book Value | $93,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,519,160 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $151,073 | DepreciationAmt |
| Book Value | $2,368,087 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $205,772 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $21,065 | DepreciationAmt |
| Book Value | $184,707 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,186,430 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $491,423 | DepreciationAmt |
| Book Value | $695,007 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $185,079 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $25,934 | DepreciationAmt |
| Book Value | $159,145 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,499,946 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED COMPENSATED ABSENCES | $54,367 |
| CREDIT CARD PAYABLE | $5,755 |
| PAYROLL WITHHOLDINGS | $4,674 |
| Rounding | $3 |
| SALARIES PAYABLE | $102,199 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $166,998 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $10,015,564 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $10,015,564 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $10,015,564 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,689,708 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $5,689,708 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $5,689,708 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (true) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
Organization Business Name OrganizationBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEVELOPMENT SYSTEMS INT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1840 | AddressLine1Txt |
| City | LEXINGTON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29071 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | FUND RAISING | ActivityTxt |
| Fundraiser Control Of Funds | false | FundraiserControlOfFundsInd |
| Gross Receipts | $2,065,854 | GrossReceiptsAmt |
| Retained By Contractor | $22,800 | RetainedByContractorAmt |
| Net To Organization | $2,043,054 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $2,065,854 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $22,800 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $2,043,054 | TotalNetToOrganizationAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|
| BENJAMIN A CAREY | ||||
| PSYCHIATRIST | $157,655 | $157,655 | ||
| ETHAN T COLLINS | ||||
| NURSE PRACTIONER | $190,614 | $190,614 | ||
| OLIVIA STALLARD | ||||
| DENTIST | $160,872 | $160,872 | ||
| PAULA HILL-COLLINS | ||||
| Clinical Director | $221,590 | $221,590 | ||
| RACHEL HELTON | ||||
| Grant Manager | $244,812 | $244,812 | ||
| ROSS B ISAACS | ||||
| PHYSICIAN | $160,400 | $160,400 | ||
| TERESA TYSON | ||||
| PRESIDENT & CEO | $269,292 | $269,292 | $70,655 | $70,655 |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 6 | ContributionCnt |
| Noncash Contributions Rpt F990 | $63,516 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | CLOSING PRICE | MethodOfDeterminingRevenuesTxt |
Securities Closely Held Stock SecuritiesCloselyHeldStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $50,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | PAR VALUE | MethodOfDeterminingRevenuesTxt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $35,897 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | IN KIND RENT | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $30,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | The 990 goes through an extensive review process. Internally, the 990 return is prepared by Larry Sturgill, CPA, an independent accounting firm, and a draft of Form 990 tax return is sent to the President and CEO and senior management for an internal review. The Health Wagon's financial liaison further reviews the 990 tax return after managment and makes changes if needed.The final reviewed copy of the 990 tax return is sent to the President and CEO. The President and CEO distributes the final copy to the Finance Committee for final review and thereafter with the Board of Trustees. Larry Sturgill, CPA presents the 990 tax return to the full Board of Trustees and a vote is tendered to accept the final form. The final 990 tax return is given to the President and CEO for signature and a copy is given to all seated Board of Trustees before filing with the IRS.In addition to the procedures noted above, programs are routinely monitored post-implementation and are reviewed for independently contracted financial audits to ensure the cost incurred and claimed have been properly reported and reasonably stated in compliance with terms of the agreement. Additionally,internal audits are conducted to ensure the quality of completed projects. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | The Health Wagon conducts annual board training, including periodic training on The Health Wagons conflict of interest policy, the annual disclosures required, and the process for review and approval of any related party transactions. The Executive committee of the Board of Directors, with the assistance of general counsel, oversees the submission of the annual disclosures by the directors, officers, trustees, and key employees, reviews the disclosures to determine whether there are interests that could give rise to conflicts, and monitors overall compliance with the policy. If any actual or potential conflicts were to arise, the general counsel would work with the Executive Committee, the Board of Trustees, and management, as appropriate, to facilitate the assessment of the fairness of the deliberations or voting regarding the transaction and otherwise monitor compliance with the policy. The Health Wagon has a conflict of interest statement and trustees are asked to sign annually. In connection with any actual or possible conflict of interest, any trustees, officer, key employee or member of a committee with the governing board must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the Board of Trustees and/or members of the committee considering the proposed transactions, initiatives, or arrangements. Each Board of Trustee shall annually sign a statement which affirms such person:a.Has received a copy of the conflict of interest policy,b.Has read and understands the conflict of interest policy, c.Has agreed to comply with the conflict of interest policyInterested persons shall disclose or update their interests that may have conflicting interests, family members or other business dealings. This can include any type of transactions or affiliations with businesses arising from any family members or their dealings.To ensure The Heath Wagon continues to operate in a manner that is consistent with charitable purposes and does not engage in activities that could jeopardize its tax-exempt status, periodic and consistent reviews yearly will be done. It will entail a.Whether compensation arrangement and benefits are reasonable.b.If joint partnerships and ventures are consistent with The Health wagons written policies and procedures. That they are properly recorded, include reasonable investment or payment for goods and services, further charitable purposes and do not result in inurement, impermissible private benefit or in an excess benefit transaction.c.Whether the Board of directors and all of those committed to The Health Wagons cause are properly implementing this conflict interest of interest policy.d.Whether any improvements should be made to this conflict of interest policy.When complying with this conflict of interest policy the Health Wagon may, but not need, use outside counsel and if indeed they are used their use shall not relieve the board of directors of its responsibility under this conflict of interest policy.If the Board of directors determines that there is a conflict of interest it shall adhere to the following proceduresa.The chairperson of the board shall appoint someone that is not of interest to investigate the proposed transaction or arrangement.b.After exercising due diligence, the board of directors shall make a determination whether the health wagon can obtain with reasonable efforts a more advantageous transaction or arrangement from a person or entity that would not give rise to a conflict of interest.If a more advantageous transaction or arrangement is not reasonably possible under circumstances not producing a conflict of interest, the board of directors will make a determination by a majority vote of the disinterested board members only whether to continue with said transactions. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | The Health Wagons Board of Trustees and/or personnel committee uses appropriate comparability data gathered largely from Guidestars Nonprofit Compensation Report along with professional health care professional data sources and contemporaneous documentation regarding compensation of the President and CEO. Guidestars Nonprofit Compensation Report allows for independent compensation reviews and confirms large scale nonprofit compensation analysis based entirely on IRS data. The President and CEOs salary is supported by grants, typically federal, and does not come from individual donations. The President and CEO serves as the project officer on several grants usually involving health metrics and high-level programmatic implementation for advancing health care for the region. Also, she serves as a nurse practitioner serving in a clinician role. The most recent compensation review occurred in 2021. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | The Health Wagon purchases a widely used independent compensation survey published by Guidestars Nonprofit Compensation Guide. The President and CEO and/or Personnel Committee performs an annual evaluation and compensation review of key employees. The most recent compensation review occurred in 2021. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Governing Documents Disclosure Explanation Summary: The Health Wagons governing documents, conflict of interest policy, and form 990s are available to the public upon request by emailing drtysonnp@thhealthwagon.org. The organization's annual reports and annual financial statements are available online at www.thehealthwagon.org. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | APPALACHIAN CENTER FOR EXECELLENCE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 90 | AddressLine1Txt |
| City | COEBURN | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24230 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 833107705 | EIN |
| Primary Activities | HEALTH CARE/CLINIC | PrimaryActivitiesTxt |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Exempt Code Section | 501(3)(c) | ExemptCodeSectionTxt |
| Public Charity Status | 170 (b)(1)(A) (iii) | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | APPALACHIAN CENTER FOR EXECELLENCE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | e | TransactionTypeTxt |
| Involved | $391,188 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |
Comments