2019-02-06T15:44:06-06:00 2018-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 W 22ND ST STE 1100 OAK BROOK IL 60523 990 2017-07-01 363828320 PCC COMMUNITY WELLNESS CENTER PCCC 7083830113 14 WEST LAKE STREET OAK PARK IL 60302 ROBERT J URSO PRESIDENT & CEO 7083830113 2019-01-31 1 CHRIS MANDERFIELD P01238973 6305738600 2019-01-25 67.137.57.251 2019-01-31 14:02:10 CS P B78854EE20A5AAAEA57700933C1E697C4E2B71FA EF3A95D8828653F7575E562EBE88CEDFA08B144E 2017 2019-02-21 02:37:17Z ROBERT J URSO 14 WEST LAKE STREET OAK PARK IL 60302 38983548 0 X WWW.PCCWELLNESS.ORG X 1992 IL PROMOTE HEALTHCARE SERVICE PROGRAMS FOR MEDICALLY UNDERSERVED LIVING IN CHICAGO COMMUNITIES 12 12 473 12 0 0 8817551 8407447 28717033 30386578 -4184 22577 278458 166946 37808858 38983548 0 0 0 0 25744025 23991860 0 0 56677 10268239 11622670 36012264 35614530 1796594 3369018 32047208 33296079 16722713 10412869 15324495 22883210 X THE MISSION OF PCC COMMUNITY WELLNESS CENTER IS TO IMPROVE HEALTH OUTCOMES FOR THE MEDICALLY UNDERSERVED COMMUNITY THROUGH THE PROVISION OF HIGH QUALITY, AFFORDABLE, AND ACCESSIBLE PRIMARY HEALTH CARE AND SUPPORT SERVICES. ANCHORED WITH FAMILY MEDICINE, WE ARE COMMITTED TO SERVING THE NEEDS OF ALL PEOPLE IN ALL STAGES OF LIFE. 0 0 30434056 30553524 PCC PROVIDES HEALTH CARE SERVICES TO THE COMMUNITY. PCC HEALTH CARE SERVICES INCLUDE: PEDIATRIC AND ADOLESCENT HEALTH CARE THAT INCLUDES WELL-CHILD EXAMS, IMMUNIZATIONS, SICK INFANT/CHILD EXAMS, SCHOOL AND SPORTS PHYSICALS, AND LEAD SCREENINGS; WOMEN'S HEALTH CARE (OB/GYN) THAT INCLUDES MATERNITY CARE AND DELIVERY, PAP SMEARS, AND BREAST CANCER SCREENINGS; ADULT HEALTH CARE; SENIOR HEALTH CARE; DIAGNOSIS AND TREATMENT OF ILLNESS; DISEASE SCREENING AND PREVENTION; FAMILY PLANNING (BIRTH CONTROL); MANAGEMENT OF CHRONIC ILLNESSES SUCH AS ASTHMA, DIABETES, AND HIGH BLOOD PRESSURE; HIV TESTING, COUNSELING, AND PRIMARY CARE; AND DENTAL CARE AND REFERRAL. 30434056 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 79 0 473 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 IL X PATRICK GARRICK 7083830113 14 WEST LAKE STREET OAK PARK IL 60302 RON AUSTIN CHAIRPERSON 2.00 2.00 X X 0 0 0 CAROLYN FITZPATRICK MD VICE CHAIRPERSON 2.00 X X 0 0 0 KENNETH BLAIR MD TREASURER 2.00 2.00 X X 0 0 0 MELINDA MALECKI SECRETARY 2.00 X X 0 0 0 VELDA BRUNNER DIRECTOR 2.00 X 0 0 0 BARBARA DIGGINS DIRECTOR 2.00 X 0 0 0 PATRICIA FORD DIRECTOR 2.00 X 0 0 0 JOHN MCDONNELL DIRECTOR 2.00 2.00 X 0 0 0 MARIANA OSORIA DIRECTOR 2.00 X 0 0 0 TERESA REYES DIRECTOR 2.00 X 0 0 0 SHAWNDA D STEER DIRECTOR 2.00 X 0 0 0 BARBARA VANEK DIRECTOR 2.00 X 0 0 0 ROBERT J URSO PRESIDENT & CEO 40.00 2.00 X 321519 0 8476 PAUL S LUNING MD CHIEF MEDICAL OFFICER 40.00 X 229626 0 22110 PATRICK GARRICK CHIEF FINANCIAL OFFICER 40.00 2.00 X 148336 0 6599 LYNN HOPKINS CHIEF OPERATING OFFICER 36.00 X 137970 0 0 KATHERINE SUBERLAK CHIEF POPULATION HEALTH OFFICER - THROUGH 11/2017 40.00 X 125835 0 14246 AMANDA BROOKS CHIEF POPULATION HEALTH OFFICER AS OF 12/17 40.00 X 71440 0 0 CHRISTINE SWARTZ MEDICAL DIRECTOR 40.00 X 261145 0 6599 KAROLE A LAKOTA-TREESE MD MEDICAL DIRECTOR OF PI 40.00 X 275512 0 18624 SHERIF MILIK FAMILY PRACTICE PHYSICIAN 40.00 X 321171 0 13222 YAM-SHUN TONG OB/GYN PHYSICIAN 40.00 X 449297 0 13222 LOPEZ BERTHA OB/GYN PHYSICIAN 40.00 X 227530 0 23920 2569381 0 127018 40 0 1 0 STAFF CARE INC 12400 HIGH BLUFF DRIVE SAN DIEGO CA 92130 STAFFING SERVICE 340238 US SECURITY ASSOCIATES INC 200 MANSELL COURT 5TH FLOOR ROSWELL GA 30076 SECURITY GUARD SERVICES 284528 B AND B MAINTENANCE INC 537 CAPITAL DRIVE LAKE ZURICH IL 60047 PROFESSIONAL BUILDING SERVICES 160576 DCG CONSULTING INC 5826 S MADISON ST HINSDALE IL 60521 IT CONSULTING 120000 ALLIANCE OF CHICAGO 215 W OHIO STREET 4TH FLOOR CHICAGO IL 60654 MEDICAL BILLING SERVICES 112162 5 200000 7065236 1142211 8407447 NET PATIENT SERVICE FEES 621400 22780163 22780163 340B 621400 6509431 6509431 BONUSES & INCENTIVES 621400 1096984 1096984 30386578 22577 22577 MISC INCOME 900099 166946 166946 166946 38983548 30553524 0 22577 1086156 158185 927971 19543777 17833759 1710018 1845932 1609889 236043 1515995 1322142 193853 36270 25133 10563 574 63803 44211 18581 1011 3377663 2340826 983783 53054 669792 516190 153602 128681 89168 37475 2038 213046 189361 23685 150194 121065 29129 164724 17323 147401 1213406 841711 371695 99308 3013 96295 MEDICAL SUPPLIES 3667594 3654124 13470 DUES AND LICENSES 1614612 1545277 69335 REPAIRS AND MAINTENANCE 135974 104461 31513 MISCELLANEOUS 87603 18218 69385 35614530 30434056 5123797 56677 9205903 12057379 1182888 2141252 1312637 225633 3305656 1552321 562034 451072 24874429 9078498 16470590 15795931 7500 7500 1064991 32047208 33296079 613417 2344103 164955 118198 14270017 7950568 1674324 16722713 10412869 X 14941450 22883210 383045 0 15324495 22883210 32047208 33296079 X 3369018 4189697 X X 0 1 X 1 1 1 X 0 1 0 0 0 0 0 0 0 0 0 PART II-B, LINE 1: NACHC CONFERENCE(ADVOCACY COMMITTEE) - EMPLOYEE TRAVEL AND TIME: $3,205 519000 519000 519000 519000 14894177 2790867 12103310 4130973 1861130 2269843 3831988 3205331 626657 1498291 1221170 277121 15795931 X PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). IN ADDITION, PCC QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. THE ORGANIZATION DETERMINED THAT IT WAS NOT REQUIRED TO RECORD A LIABILITY RELATED TO UNCERTAIN TAX POSITIONS. 1 X X X X 0 0 0 0 0 0 0 0 0 ROBERT J URSO PRESIDENT & CEO 301519 0 20000 0 0 0 0 0 8476 0 329995 0 0 0 PAUL S LUNING MD CHIEF MEDICAL OFFICER 212260 0 17366 0 0 0 0 0 22110 0 251736 0 0 0 PATRICK GARRICK CHIEF FINANCIAL OFFICER 137724 0 10612 0 0 0 0 0 6599 0 154935 0 0 0 CHRISTINE SWARTZ MEDICAL DIRECTOR 223080 0 38065 0 0 0 0 0 6599 0 267744 0 0 0 KAROLE A LAKOTA-TREESE MD MEDICAL DIRECTOR OF PI 221335 0 54177 0 0 0 0 0 18624 0 294136 0 0 0 SHERIF MILIK FAMILY PRACTICE PHYSICIAN 312005 0 9166 0 0 0 0 0 13222 0 334393 0 0 0 YAM-SHUN TONG OB/GYN PHYSICIAN 448497 0 800 0 0 0 0 0 13222 0 462519 0 0 0 LOPEZ BERTHA OB/GYN PHYSICIAN 226730 0 800 0 0 0 0 0 23920 0 251450 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THERE IS AN INTERNAL REVIEW PROCESS WHICH IS PERFORMED BY THE CHIEF FINANCIAL OFFICER AND CHIEF EXECUTIVE OFFICER. SUBSEQUENT TO THAT REVIEW, THE 990 IS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS WHO THEN SUBMITS THE RETURN TO THE ENTIRE BOARD FOR APPROVAL. A COPY OF THE RETURN IS KEPT ON RECORD FOR PUBLIC REVIEW SHOULD THERE BE SUCH A REQUEST. FORM 990, PART VI, SECTION B, LINE 12C ALL TRANSACTIONS AND PROCESSES ARE REVIEWED AND MONITORED THROUGH POLICY, EXECUTIVE MANAGEMENT, AND RATIFIED BY THE VOTING MEMBERS OF THE BOARD, IF NECESSARY. ALL STAFF AND BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT WHICH IS KEPT IN EACH STAFF AND BOARD MEMBERS' FILES. DISCLOSURE OF CONFLICT OF INTEREST POLICY QUESTION IS PRESENTED TO EVERY STAFF OR BOARD MEMBER DURING THE RECRUITING OR HIRING PROCESS. FURTHERMORE, AT ANY JUNCTURE WHEN MAJOR DECISIONS ARE ABOUT TO BE MADE, INDIVIDUALS RAE ASKED TO DISCLOSE ANY CONFLICTS THAT MAY EXIST. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS OF DETERMINING COMPENSATION FOR THE CEO AND OTHER KEY OFFICERS OF THE ORGANIZATION IS DONE THROUGH A REVIEW AND APPROVAL PROCESS VIA THE GOVERNING BODY, AND SUBJECT TO RATIFICATION OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS FROM PCC FOUNDATION 6,189,697. TRANSFER OF NET ASSETS TO PCC FOUNDATION -2,000,000. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PCC QALICB LLC 14 WEST LAKE STREET OAK PARK IL 60302 273160926 SEE PART VII IL 9780 0 PCC COMMUNITY WELLNESS CENTER PCC FOUNDATION 14 LAKE STREET OAK PARK IL 60302 475608703 SEE PART VII IL 501(C)(3) LINE 12A, I PCC COMMUNITY WELLNESS CENTER 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 PCC FOUNDATION C 200000 FAIR MARKET VALUE PCC FOUNDATION R 2000000 FAIR MARKET VALUE PCC FOUNDATION S 6189697 FAIR MARKET VALUE FORM 990, SCHEDULE R, PART I, LINE 1, COLUMN (B) & PART II, COLUMN (B) PCC QALICB LLC SERVED AS THE QUALIFIED ACTIVE LOW-INCOME COMMUNITY BUSINESS THAT PROVIDES CHARITABLE ACTIVITIES IN THE DISTRESSED COMMUNITY. THIS ENTITY WAS DISSOLVED DURING THE YEAR. THE PCC FOUNDATION CONDUCTS FUNDRAISING ACTIVITIES FOR PCC COMMUNITY WELLNESS CENTER ("CENTER") AND INTENDS TO AWARD GRANTS TO THE CENTER UPON REQUEST.