THE WALLACE MEDICAL CONCERN: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
THE WALLACE MEDICAL CONCERN (EIN 93-0853709)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-02
IRS object ID
201701229349300345
Schema version
2015v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-05-02T11:34:09-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110700 NORTHUP WAY SUITE 200AddressLine1Txt
CityBELLEVUECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN930853709EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE WALLACE MEDICAL CONCERNBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWALLBusinessNameControlTxt
Phone5034891760PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1124 NE 181ST AVENUE NO 103AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97230ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARILYNN WEBERPersonNm
Person TitleTREASURERPersonTitleTxt
Phone5034891760PhoneNum
Signature2017-03-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKURT BENNION CPAPreparerPersonNm
PTINP01469618PTIN
Phone4252506100PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLISA CLINEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1124 NE 181ST AVENUE NO 103AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97230ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,511,212GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WALLACEMEDICAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1984FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionPROVIDE HEALTH SERVICES TO THOSE IN NEED IN THE PORTLAND AND GRESHAM METROPOLITAN AREA.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee61TotalEmployeeCnt
Total Volunteers63TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,114,329PYContributionsGrantsAmt
CY Contributions Grants$2,749,641CYContributionsGrantsAmt
PY Program Service Revenue$1,875,233PYProgramServiceRevenueAmt
CY Program Service Revenue$2,657,341CYProgramServiceRevenueAmt
PY Investment Income$250PYInvestmentIncomeAmt
CY Investment Income$372CYInvestmentIncomeAmt
PY Other Revenue$207,859PYOtherRevenueAmt
CY Other Revenue$103,858CYOtherRevenueAmt
PY Total Revenue$4,197,671PYTotalRevenueAmt
CY Total Revenue$5,511,212CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,128,421PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,276,141CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$36,012PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$23,188CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$140,397CYTotalFundraisingExpenseAmt
PY Other Expenses$1,419,642PYOtherExpensesAmt
CY Other Expenses$2,237,749CYOtherExpensesAmt
PY Total Expenses$3,584,075PYTotalExpensesAmt
CY Total Expenses$4,537,078CYTotalExpensesAmt
PY Revenues Less Expenses$613,596PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$974,134CYRevenuesLessExpensesAmt
Total Assets BOY$1,314,429TotalAssetsBOYAmt
Total Assets EOY$2,253,720TotalAssetsEOYAmt
Total Liabilities BOY$297,506TotalLiabilitiesBOYAmt
Total Liabilities EOY$262,668TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,016,923NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,991,052NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE WALLACE MEDICAL CONCERN ("WMC") PROVIDES AN OPEN DOOR TO EXCEP- TIONAL HEALTH 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.WMC PROVIDES AN OPEN DOOR TO EXCEPTIONAL HEALTH SERVICES AND CONNECTIONS THAT SUPPORT INDIVIDUALS AND THEIR FAMILIES IN HEALTHY LIVING. WMC HAS A 31-YEAR RECORD OF PROVIDING MEDICAL SERVICES AND HAS DISTINGUISHED ITSELF AS A PATIENT-FOCUSED, INNOVATIVE HEALTH CARE ORGANIZATION. WMC BECAME A FEDERALLY QUALIFIED HEALTH CENTER IN JUNE OF 2012, ALLOWING FOR EXPANSION OF SERVICES AND IMPLEMENTATION OF PRIMARY CARE THAT OFFERS A COMPREHENSIVE MEDICAL HOME AND CONTINUITY OF CARE FOR PATIENTS AND THEIR FAMILIES. WMC'S INCREASING CAPACITY TO PROVIDE HIGH QUALITY HEALTH SERVICES IS THE RESULT OF ITS SUCCESS AT ATTRACTING AND MAINTAINING SKILLED AND COMMITTED MEDICAL PROFESSIONALS, ITS INNOVATIVE PARTNERSHIPS, AND THE HIRING OF BILMissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,570,148ExpenseAmt
Grant$0GrantAmt
Revenue$2,657,341RevenueAmt
DescTHE WALLACE MEDICAL CONCERN (WMC) PROVIDES AN OPEN DOOR TO EXCEPTIONAL HEALTH SERVICES AND CONNECTIONS THAT SUPPORT INDIVIDUALS AND THEIR FAMILIES IN HEALTHY LIVING. WMC HAS DISTINGUISHED ITSELF FOR OVER THIRTY YEARS AS A PATIENT-FOCUSED, INNOVATIVE HEALTH CARE ORGANIZATION OFFERING A WIDE ARRAY OF SERVICES. SINCE RECEIVING DESIGNATION AS A FEDERALLY QUALIFIED HEALTH CENTER IN 2012, WMC HAS EXPANDED SERVICES TO INCLUDE COMPREHENSIVE PRIMARY CARE, BEHAVIORAL/MENTAL HEALTH AND IN 2016, ORAL HEALTH CARE. WE OFFER OUR PATIENTS AND THEIR FAMILIES A COMPREHENSIVE HEALTH HOME PROVIDING CONTINUITY OF CARE AND FULL INTEGRATION OF MEDICAL AND DENTAL SERVICES. CONTINUED ON SCHEDULE O. WMC'S INCREASING CAPACITY TO DELIVER HIGH-QUALITY, MULTI-DISCIPLINARY CARE IS THE RESULT OF ITS SUCCESS AT ATTRACTING AND RETAINING SKILLED AND COMMITTED HEALTH PROFESSIONALS, A CULTURALLY-APPROPRIATE APPROACH, INNOVATIVE PARTNERSHIPS, AND ONGOING COMMUNITY INVESTMENT. OUR PROGRAMS ADDRESS SOCIAL DETERMINANTS OF HEALTH SUCH AS NUTRITION/FOOD ACCESS AND ORAL HEALTH, WHICH PLAY A PIVOTAL ROLE IN CHILDREN'S DEVELOPMENT. OUR COMPREHENSIVE PRIMARY CARE SERVICES INCLUDE WELL CHILD, WOMEN'S HEALTH, BEHAVIORAL HEALTH AND CHRONIC DISEASE MANAGEMENT. WE OFFER SPECIALTY CLINICS IN DERMATOLOGY, PODIATRY, OPTOMETRY, CHIROPRACTIC AND DENTAL. WE ALSO PLAY A CRITICAL ROLE AS A GATEWAY TO THE LARGER HEALTH CARE SYSTEM, SECURING REFERRALS FOR NO-COST SPECIALTY AND HOSPITAL CARE. WITH BILINGUAL STAFF, PROFESSIONAL INTERPRETER VOLUNTEERS, AND AN EMPHASIS ON HEALTH LITERACY, HEALTH EDUCATION AND PREVENTION, WMC IS ABLE TO PROVIDE CULTURALLY APPROPRIATE CARE TO NON-ENGLISH SPEAKING PATIENTS. THE HEALTH ACCESS WINDOW AT THE MEXICAN CONSULATE OFFERS HEALTH PROMOTION AND DISEASE PREVENTION ASSISTANCE. THE MOBILE MEDICAL CLINIC AND THE NEW ROCKWOOD CLINIC LOCATED OFF THE MAX LINE OFFER ACCESSIBILITY TO THOSE WITH LIMITED TRANSPORTATION OPTIONS.Desc
Total Program Service Expenses$3,570,148TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document15IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee61EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Form1098 C Filed0Form1098CFiledInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AMY BRISSONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5039070594PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1124 NE 181ST AVE STE 103AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97230ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
MAUREEN WRIGHT MD
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
LISA GOREN
VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
PATRICIA HICKS
SECRETARY1.00Yes (X)Yes (X)$0$0$0
MARILYNN WEBER
SECRETARY & TREASURER1.00Yes (X)Yes (X)$0$0$0
ADELE ATWOOD
DIRECTOR1.00Yes (X)$0$0$0
VIRGINIA CORNYN
DIRECTOR1.00Yes (X)$0$0$0
CARLOS GALEANA
DIRECTOR1.00Yes (X)$0$0$0
DEBORAH HEDGES
DIRECTOR (THROUGH NOVEMBER 2015)1.00Yes (X)$0$0$0
LYNN KETCH
DIRECTOR1.00Yes (X)$0$0$0
MARVA MITCHELL
DIRECTOR (THROUGH JULY 2015)1.00Yes (X)$0$0$0
TAMRA ORR
DIRECTOR1.00Yes (X)$0$0$0
DAVID WOLF
DIRECTOR1.00Yes (X)$0$0$0
LISA CLINE
CHIEF EXECUTIVE OFFICER50.00Yes (X)$117,950$0$5,649
AMY BRISSON
CHIEF FINANCIAL OFFICER43.00Yes (X)$85,948$0$6,201
AZAD JOHN-SALIMI MD
PHYSICIAN40.00$144,569$0$4,476Yes (X)
ANNA JIMINEZ MD
MEDICAL DIRECTOR40.00$120,435$0$9,294Yes (X)
JULIA FREY
PHYSICIAN ASSISTANT40.00$103,022$0$8,597Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$571,924TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$34,217TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAVID GORCHOFFBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line12438 HUMBOLDT STAddressLine1Txt
CitySANTA ROSACityNm
State AbbreviationCAStateAbbreviationCd
ZIP95404ZIPCd
FieldValueIRS element (for citing)
ServicesMEDICAL CONSULTINGServicesDesc
Compensation$104,194CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$1,717,293GovernmentGrantsAmt
All Other Contributions$1,032,348AllOtherContributionsAmt
Noncash Contributions$105,865NoncashContributionsAmt
Total Contributions$2,749,641TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT BILLING621110$2,255,350$2,255,350
CCO INCENTIVE621110$401,991$401,991
FieldValueIRS element (for citing)
Total Program Service Revenue$2,657,341TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$372TotalRevenueColumnAmt
Exclusion$372ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$4,538RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$4,538RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,538TotalRevenueColumnAmt
Exclusion$4,538ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MEANINGFUL USE REVENUE900099$72,250$72,250
OTHER INCOME900099$27,070$27,070
FieldValueIRS element (for citing)
Other Revenue Total$99,320OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,511,212TotalRevenueColumnAmt
Related Or Exempt Func Income$2,657,341RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$104,230ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$216,011TotalAmt
Management And General$216,011ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,687,063TotalAmt
Program Services$1,422,536ProgramServicesAmt
Management And General$174,061ManagementAndGeneralAmt
Fundraising$90,466FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$23,547TotalAmt
Program Services$19,901ProgramServicesAmt
Management And General$2,360ManagementAndGeneralAmt
Fundraising$1,286FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$157,548TotalAmt
Program Services$123,898ProgramServicesAmt
Management And General$25,836ManagementAndGeneralAmt
Fundraising$7,814FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$191,972TotalAmt
Program Services$138,906ProgramServicesAmt
Management And General$44,153ManagementAndGeneralAmt
Fundraising$8,913FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$129,429TotalAmt
Program Services$2,790ProgramServicesAmt
Management And General$126,639ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,924TotalAmt
Program Services$465ProgramServicesAmt
Management And General$2,459ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$69,517TotalAmt
Program Services$1,938ProgramServicesAmt
Management And General$67,579ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$23,188TotalAmt
Fundraising$23,188FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$593,994TotalAmt
Program Services$521,135ProgramServicesAmt
Management And General$84,672ManagementAndGeneralAmt
Fundraising-$11,813FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$70,385TotalAmt
Program Services$29,869ProgramServicesAmt
Management And General$40,516ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$33,612TotalAmt
Program Services$15,677ProgramServicesAmt
Management And General$14,667ManagementAndGeneralAmt
Fundraising$3,268FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$42,854TotalAmt
Program Services$23,869ProgramServicesAmt
Management And General$17,369ManagementAndGeneralAmt
Fundraising$1,616FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$165,094TotalAmt
Program Services$133,798ProgramServicesAmt
Management And General$31,269ManagementAndGeneralAmt
Fundraising$27FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$17,061TotalAmt
Program Services$9,658ProgramServicesAmt
Management And General$7,193ManagementAndGeneralAmt
Fundraising$210FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$43,476TotalAmt
Program Services$25,813ProgramServicesAmt
Management And General$13,640ManagementAndGeneralAmt
Fundraising$4,023FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$3,181TotalAmt
Management And General$3,181ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$77,647TotalAmt
Program Services$30,840ProgramServicesAmt
Management And General$46,807ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$28,445TotalAmt
Program Services$13,435ProgramServicesAmt
Management And General$15,010ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
BAD DEBT EXPENSE$673,733$673,733
CLINICAL SUPPLIES$226,279$226,279
SMALL EQUIPMENT$27,699$23,614$1,927$2,158
VOLUNTEER MANAGEMENT$10,995$10,315$680

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$21,424TotalAmt
Program Services$121,679ProgramServicesAmt
Management And General-$109,496ManagementAndGeneralAmt
Fundraising$9,241FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,537,078TotalAmt
Program Services$3,570,148ProgramServicesAmt
Management And General$826,533ManagementAndGeneralAmt
Fundraising$140,397FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$33,406BOYAmt
EOY$249,494EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$168,422BOYAmt
EOY$213,372EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$54,491BOYAmt
EOY$257,264EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$413,026BOYAmt
EOY$366,181EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$23,444BOYAmt
EOY$46,345EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,323,871LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$202,807LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$621,640BOYAmt
EOY$1,121,064EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,314,429BOYAmt
EOY$2,253,720EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$196,832BOYAmt
EOY$259,564EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$3,104EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$100,674BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$297,506BOYAmt
EOY$262,668EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$834,170BOYAmt
EOY$1,789,187EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$182,753BOYAmt
EOY$201,865EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,016,923BOYAmt
EOY$1,991,052EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,314,429BOYAmt
EOY$2,253,720EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$974,134ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$5NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,062,396CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,540,932CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,664,756CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,114,329CurrentTaxYearMinus1YearAmt
Current Tax Year$2,749,641CurrentTaxYearAmt
Total$9,132,054TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,062,396CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,540,932CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,664,756CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,114,329CurrentTaxYearMinus1YearAmt
Current Tax Year$2,749,641CurrentTaxYearAmt
Total$9,132,054TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$9,132,054PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,681CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$901CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$77CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,350CurrentTaxYearMinus1YearAmt
Current Tax Year$4,910CurrentTaxYearAmt
Total$10,919TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,871CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,724CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,977CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$205,759CurrentTaxYearMinus1YearAmt
Current Tax Year$99,320CurrentTaxYearAmt
Total$315,651TotalAmt
FieldValueIRS element (for citing)
Total Support$9,458,624TotalSupportAmt
Gross Receipts Rltd Activities$5,163,086GrossReceiptsRltdActivitiesAmt
Public Support CY1700.96550PublicSupportCY170Pct
Public Support PY1700.96900PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER INCOME MEANINGFUL USEExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$478,049OtherCostOrOtherBasisAmt
Book Value$478,049BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$191,193OtherCostOrOtherBasisAmt
Depreciation$126,406DepreciationAmt
Book Value$64,787BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$654,629OtherCostOrOtherBasisAmt
Depreciation$76,401DepreciationAmt
Book Value$578,228BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,121,064TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$5,254,159TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$5NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$78,820DonatedServicesAndUseFcltsAmt
Revenue Not Reported$78,815RevenueNotReportedAmt
Revenue Subtotal$5,175,344RevenueSubtotalAmt
Other Revenues Not Included$335,868OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$335,868RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$5,511,212TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$4,615,898TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$78,820DonatedServicesUseFcltsAmt
Expenses Not Reported$78,820ExpensesNotReportedAmt
Expenses Subtotal$4,537,078ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$4,537,078TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:WMC IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE 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 INTERNAL REVENUE CODE. 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 TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION.
PART XI, LINE 4B - OTHER ADJUSTMENTS:CAPITAL CONTRIBUTIONS 335,868.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Email SolicitationsYes (X)EmailSolicitationsInd
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Solicitation Of Govt GrantsYes (X)SolicitationOfGovtGrantsInd
Agrmt Prof Fundraising ActyYes (1)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdActivityActivityTxtFundraiser Control Of FundsFundraiserControlOfFundsIndGross ReceiptsGrossReceiptsAmtRetained By ContractorRetainedByContractorAmtNet To OrganizationNetToOrganizationAmt
LAURA RAYMOND
4401 SE 29TH AVEPORTLANDOR97202GRANT WRITING0$357,359$3,705$353,654
DANA BROWN
2606 NE 30TH AVEPORTLANDOR97212GRANT WRITING0$111,500$5,954$105,546
COMMUNITY LINK CONSULTING
PO BOX 276NEWMAN LAKEWA99025GRANT WRITING0$0$13,530-$13,530
FieldValueIRS element (for citing)
Total Gross Receipts$468,859TotalGrossReceiptsAmt
Total Retained By Contractors$23,189TotalRetainedByContractorsAmt
Total Net To Organization$445,670TotalNetToOrganizationAmt
Licensed StatesORLicensedStatesCd

Schedule M IRS990ScheduleM

Cars And Other Vehicles CarsAndOtherVehiclesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$92,500NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$865NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescEQUIPMENTDesc
Contribution1ContributionCnt
Noncash Contributions Rpt F990$12,500NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2DURING THE FISCAL YEAR, THE WALLACE MEDICAL CONCERN BEGAN OFFERING DENTAL SERVICES TO THE COMMUNITY.
FORM 990, PART VI, SECTION A, LINE 1THE 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 A, LINE 4THE BYLAWS WERE AMENDED IN MAY 2016 TO CLARIFY THE ORGANIZATION'S HEALTH SERVICES PURPOSE AND UPDATE DISSOLUTION REQUIREMENTS TO COMPLY WITH STATE LAWS.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 WAS REVIEWED BY MANAGEMENT AND THE FINANCE COMMITTEE. A COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CEACH 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, THE 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 15ATHE 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.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER PRO FEES: PROGRAM SERVICE EXPENSES 521,135. MANAGEMENT AND GENERAL EXPENSES 84,672. FUNDRAISING EXPENSES -11,813. TOTAL EXPENSES 593,994.

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