2016-10-17T09:13:58-05:00 2015-11-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2014-12-01 561004791 WAKE HEALTH SERVICES INC % PENELLA WASHINGTON WAKE 9192502923 1001 ROCK QUARRY RD RALEIGH NC 27610 PENELLA WASHINGTON CEO 9192502923 2016-10-14 true Brian D Todd P00422601 4178658701 2014 2017-02-10 21:41:12Z X ADVANCE COMMUNITY HEALTH PENELLA WASHINGTON 1001 ROCK QUARRY RD RALEIGH NC 27610 10765624 false X WWW.ADVANCECHC.ORG X 1972 NC WHSI DBA ADVANCE COMMUNITY HEALTH PROVIDES QUALITY HEALTH CARE IN SIX LOCATIONS TO THE RESIDENTS OF WAKE AND FRANKLIN COUNTIES, NC. SEE SCH O FOR ADDITIONAL DETAILS X 13 13 193 14 0 0 3161496 3905757 6774417 6859867 -4119 0 0 0 9931794 10765624 0 0 0 0 7836692 8230845 0 0 17636 3193121 3766098 11029813 11996943 -1098019 -1231319 5097167 2270962 2040463 2516733 3056704 -245771 X TO DELIVER QUALITY, COMPASSIONATE PRIMARY HEALTH CARE - EVERY PATIENT, EVERY TIME - IN RESPONSE TO NEEDS OF OUR COMMUNITIES. false false 4931868 3868965 FAMILY MEDICINE: DURING FY2015, FAMILY MEDICINE SERVICES WERE PROVIDED RESULTING IN 30,425 ENCOUNTERS. THESE SERVICES INCLUDED PREVENTATIVE, ACUTE AND CHRONIC CARE SERVICES AS WELL AS DIABETIC CARE AND EDUCATION, NUTRITION COUNSELING, ASTHMA CARE, WOMEN'S HEALTH, WEIGHT MANAGEMENT AND HYPERTENSION. 1559010 2291196 PEDIATRICS: THE PEDIATRIC PRACTICE PROVIDES A FULL RANGE OF PRIMARY MEDICAL SERVICES TO ITS PATIENTS. EMPHASIS WAS PLACED ON WELL CHILD CARE, IMMUNIZATIONS, ASTHMA CARE AND PREVENTION AND WEIGHT MANAGEMENT/NUTRITION COUNSELING. SERVICES PROVIDED RESULTED IN 9,509 PEDIATRIC ENCOUNTERS. 637095 651688 DENTISTRY: THE DENTAL PROGRAM EXPANDED CONSIDERABLY IN NOVEMBER 2015. THE DENTAL PROGRAM RELOCATED AND MOVED INTO A STATE OF THE ART 10 OPERATORY SPACE. SERVICES HISTORICALLY INCLUDED ORAL HYGIENE, RESTORATIVE SERVICES AND EXTRACTIONS. WITH THE RELOCATION THE FIRST INITIATIVE WAS TO PARTNER WITH THE PEDIATRICS PROGRAM TO ENSURE SCHOOL AGED CHILDREN AND BABIES FROM THE FIRST TOOTH ARE RECEIVING APPROPRIATE DENTAL CARE. IN ADDITION, AN INITIATIVE TO FULLY INTEGRATE ORAL HEALTH SERVICES WITH ADVANCE'S MEDICAL PROGRAM BEGAN. IN 2015, THE DENTAL STAFF PROVIDED 3,894 VISITS. 367267 48018 7495240 true true false true false false false false false false true false false true false false false true false false false false false false false false false false false true false false false false false false false false true false false true false true true true false false true 23 0 true 193 true false false false false false false false false false false X 13 13 false false true false false false false true true false false true true true true true true true true false X PENELLA WASHINGTON 9192502923 1001 ROCK QUARRY ROAD RALEIGH NC 27610 JAMES R ALLEN BOARD MEMBER 3.0 0.0 X 0 0 0 ELAINE BROWN CHAIRPERSON 3.0 0.0 X X 0 0 0 DARRELL GRIER BOARD MEMBER ENDING 06/2015 2.0 0.0 X 0 0 0 TARA MINTER BOARD MEMBER 2.0 0.0 X 0 0 0 DESIREE PETERSON BOARD MEMBER 2.0 0.0 X 0 0 0 JAMES W TEAGLE TREASURER 3.0 0.0 X X 0 0 0 MARQUETTE DAVIS RUSSELL SECRETARY 2.0 0.0 X X 0 0 0 ACIE WARD VICE CHAIR 2.0 0.0 X X 0 0 0 HAROLD R HICKS BOARD MEMBER 2.0 0.0 X 0 0 0 HERMAN P WILKINS BOARD MEMBER 2.0 0.0 X 0 0 0 CARLA MENA BOARD MEMBER 2.0 0.0 X 0 0 0 RAJ BAHADUR BOARD MEMBER 2.0 0.0 X 0 0 0 ROBERT H TOLER BOARD MEMBER 2.0 0.0 X 0 0 0 LAINI JARRETT BOARD MEMBER BEGINNING 8/2015 2.0 0.0 X 0 0 0 PENELLA WASHINGTON CHIEF EXECUTIVE OFFICER 40.0 0.25 X 158829 0 13446 CHARLES FAUST CHIEF OPERATING OFFICER 40.0 0.25 X 116289 0 11626 NICOLE BLAKE HUMAN RESOURCES EXECUTIVE 40.0 0.0 X 40942 0 2603 JACK JUSTICE CHIEF FINANCIAL OFFICER 40.0 0.25 X 2115 0 115 DAVID GOFF CHIEF MEDICAL OFFICER 40.0 0.0 X 184077 0 13480 DORIS BATTS-MURRAY PHYSICIAN 40.0 0.0 X 132676 0 13822 SHELLY RICKERT DENTIST 40.0 0.0 X 135625 0 12302 FARAZ AKHTAR PHYSICIAN 40.0 0.0 X 167033 0 2769 RADHA GUDDATI PHYSICIAN 40.0 0.0 X 115087 0 12890 JILL WRIGHT PHYSICIAN 40.0 0.0 X 140214 0 6447 1192887 0 89500 9 false true false BKD LLP AUDIT/TAX/COST RPT 130752 TINKBIRD HEALTHCARE STAFFING STAFFING 136060 2 3751819 153938 90770 3905757 NET PATIENT SERVICE REVENUE 624100 6738821 6738821 EHR INCENTIVE REVENUE 624100 121046 121046 6859867 0 0 0 0 0 0 0 0 0 0 0 10765624 6859867 0 0 0 0 543523 436764 106759 0 6558010 4024084 2533926 88761 52255 36506 456208 287868 168340 584343 372670 211673 0 0 18333 18333 0 0 0 458321 146436 311885 13996 8324 5672 555218 279742 257840 17636 127679 127679 0 692545 405968 286577 29136 2739 26397 0 71541 71541 23859 14191 9668 0 255840 152165 103675 54301 32296 22005 BAD DEBT 788445 788445 MEDICAL SUPPLIES & DRUGS 491293 491293 RECRUITING & RETENTION 144660 144660 LICENSES, DUES, SUBSCRIPTION 40931 40931 11996943 7495240 4484067 17636 128131 177866 0 0 17880 41507 450000 267728 0 0 0 0 0 0 58154 100814 76421 192083 1921674 1477894 3105299 443780 0 0 0 0 0 5100 0 0 1261282 1042084 5097167 2270962 1015345 1167599 0 0 0 0 0 0 0 0 0 0 1025118 1349134 0 0 0 0 2040463 2516733 X 3056704 -245771 0 0 0 0 3056704 -245771 5097167 2270962 X -1231319 -37027 -2034129 X X false true X true true true X 4118660 3710872 2938438 3161496 3905757 17835223 7552170 6857936 6783388 6774417 6859867 34827778 0 0 0 11670830 10568808 9721826 9935913 10765624 52663001 0 0 0 52663001 243 77 320 0 243 77 320 0 0 11671073 10568885 9721826 9935913 10765624 52663321 0.99999 0.99999 0.00001 0.00001 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false true false SCHEDULE C, PART II-B, QUESTION 1I DESCRIPTION OF OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE NORTH CAROLINA COMMUNITY HEALTH CENTER ASSOCIATION. A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO LOBBYING. 172821 81738 91083 1748853 1396156 352697 443780 EST AMT DUE FROM THIRD PTY PYR 1037310 OTHER ASSETS 4774 1042084 9977179 -788445 -788445 10765624 10765624 11208498 11208498 788445 788445 11996943 SCHEDULE D, PART X, QUESTION 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ ( 788,445) BAD DEBT EXPENSE SCHEDULE D, PART XII, QUESTION 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 788,445 BAD DEBT EXPENSE X X X false false false false false false false false false PENELLA WASHINGTON CHIEF EXECUTIVE OFFICER 158829 0 0 0 0 0 6353 0 7093 0 172275 0 0 0 DAVID GOFF CHIEF MEDICAL OFFICER 184077 0 0 0 0 0 7363 0 6117 0 197557 0 0 0 FARAZ AKHTAR PHYSICIAN 167033 0 0 0 0 0 0 0 2769 0 169802 0 0 0 X DENTAL EQUIPMENT 1 90770 FMV false false false FIXED ASSETS 2014-12-01 2034129 BOOK VALUE 471270222 EMERALD QUARRY 1001 ROCK QUARRY ROAD RALEIGH NC 27610 501(C)(3) true false false false SCHEDULE N, PART II, LINE 2E DIRECTOR OR TRUSTEE OF TRANSFEREE ORGANIZATION: PENELLA WASHINGTON, CEO OF WAKE HEALTH SERVICES, INC., SERVES AS A TRUSTEE FOR EMERALD QUARRY. FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION: Wake Health Services d/b/a Advance Community Health is a private, not for profit, federally qualified health center (FQHC) operating 4 practice sites and 1 outreach site in Wake and Franklin Counties. Founded in 1972, Advance provides primary care, dental, mental health and other wrap around services to all ages from newborns to senior citizens. Advance serves patients that are publicly insured (Medicare and Medicaid), commercially Insured (including persons insured through the Marketplace Exchange), Underinsured, Uninsured and Homeless populations. The staff of approximately 130 employees includes Board Certified Internists, Family Physicians, Pediatricians, Adolescent Care Specialist, Infectious Disease Physician, Physician Assistants, Family Nurse Practitioners, Registered Nurses, Licensed Clinical Social Workers, Licensed Clinical Addiction Specialist, Registered Dieticians, Case Managers, Bilingual Staff and other Clinical and Administrative Support Staff. Advance Community Health provides referrals to specialists, discounted fees, and assistance with prescriptions. In 2015, the organization served 17,879 unduplicated patients of which 1,115 were homeless and one-third were children. Approximately 90% of patients are under 200% of the Federal Poverty Level. Approximately 25% of patients are uninsured, 40% Medicaid/NC Health Choice; 21% Medicare and 14% have commercial insurance. Advance Community Health partners with local hospitals, public health, social services and community agencies to meet the needs of the communities we serve. Advance has four specialized programs on the Southeast Raleigh campus including Adolescent Health Program, CAPUS Clinic, Horizon Healthcare for the Homeless and Advance/Rex Senior Health Center. Our wraparound services include After Hours Coverage; Health Insurance Enrollment; Medicaid Eligibility Assistance; Medicare Enrollment Assistance; and Voter Registration. FORM 990, PART III, LINE 4D DESCRIPTION OF OTHER PROGRAM SERVICES: HEALTHCARE FOR THE HOMELESS: THE HORIZON HEALTHCARE FOR THE HOMELESS PROGRAM PROVIDED A FULL RANGE OF PRIMARY CARE, MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES AT THE SOUTHEAST RALEIGH MEDICAL PRACTICE AND AT THE SOUTH WILMINGTON 300 BED MEN'S SHELTER IN RALEIGH. THE HEALTHCARE FOR THE HOMELESS PROGRAM PARTNERS WITH OTHER COMMUNITY AGENCIES TO ASSIST PATIENTS WITH OTHER ENABLING SERVICES INCLUDING HOUSING, FOOD AND CLOTHING. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: ARTICLE V. STANDING COMMITTEES Section 1. Creation. The Board of Trustees shall, at the last meeting of the calendar year or at such other time as the Board shall determine, designate the following committees with responsibilities as hereinafter designated. Board committees may be augmented with advisory members, as set forth below. Advisory members are community members and business experts who volunteer to assist the Corporation's Standing Committees. Advisory members shall not serve as Trustees and shall have no voting authority on behalf of the full governing board or otherwise serve as fiduciaries and policy makers on behalf of the Corporation. Advisory members cannot serve as Chair of a Standing Committee or serve on the Executive Committee. Executive Committee: The minimum number of Trustees constituting the Executive Committee shall be five (5). The Trustees constituting the Executive Committee shall be the officers of the Corporation and the Chairpersons of the other Standing Committees. The immediate past Chairperson of the Corporation shall be a member of the Executive Committee; or has the option to serve on the Executive Committee, if they are a member of the Board of Trustees. The officers of the Corporation shall serve in those capacities on the Executive Committee. The Executive Committee shall have and may exercise all of the authority of the Board of Trustees in the management of the Corporation during the interim periods between meetings of the Board of Trustees, except as otherwise provided by law or by resolution of the Board of Trustees. When the Executive Committee takes any action on behalf of the Board between regular Board meetings, that business shall be reported and ratified at the next Board meeting. The Executive Committee shall also have the responsibility for: - working with the CEO in providing leadership in the development of the organization's long and short range plans - leading the Board in an annual review of mission and vision - reviewing and making decisions on sensitive human resources and legal matters - conducting the preliminary annual review of the CEO's performance. The final review of the CEO's performance shall be approved by the full Board of Trustees. Budget and Finance Committee: The minimum number of Trustees and advisory members constituting the Budget and Finance Committee shall be three (3), at least two (2) of whom must be Trustees. The Committee shall have the responsibility for: - overseeing the financial operations of the Corporation - overseeing the preparation of the annual budget and monitoring budget variances with actual revenue and expenditures - reviewing the Corporation's monthly financial statements - reviewing and recommending the financial and investment policies of the Corporation. The Committee shall make recommendations to the Board of Trustees for their approval. Business Strategies Committee: The minimum number of Trustees and advisory members constituting the Business Strategies Committee shall be three (3). The Committee shall have the responsibility for: - reviewing and recommending changes to hours of operation and locations - reviewing and recommending confidentiality policies to ensure the protection of proprietary and other corporate information - reviewing the Corporation's HIPAA, HITECH and corporate compliance adherence - evaluating operational activities including service utilization patterns, productivity, patient access and achievement of program objectives - overseeing organization's compliance with HRSA's 19 program requirements - reviewing and recommending human resources policies - evaluating and providing oversight with compensation and benefit plans The Committee shall make recommendations to the Board of Trustees for their approval. Fundraising Committee: The minimum number of Trustees and advisory members constituting the Fundraising Committee shall be three (3). The Committee shall have the responsibility for: - overseeing the activities of the Corporation relative to fundraising and grant development - spearheading the Corporation's capital campaign - recommending long-term fundraising strategies The Committee shall make recommendations to the Board of Trustees for their approval. Healthcare Quality and Risk Management Committee: The minimum number of Trustees and advisory members constituting the Healthcare Quality and Risk Management Committee shall be three (3). The Committee shall have the responsibility for: - reviewing and recommending improvements to the delivery of healthcare services - reviewing and recommending clinical policies - reviewing and monitoring the healthcare quality and risk management plans - reviewing and monitoring the healthcare quality indicators from HRSA and internal quality metrics - reviewing and recommending risk assessment and risk management policies - monitoring and recommending areas of focus based on quality of care indicators, health disparity data, and needs assessment data - reviewing and recommending the scope of services provided by the Corporation - reviewing and recommending the credentials of the licensed clinical staff - reviewing compliance with OSHA, CLIA, NCQA and other regulatory agency guidelines and requirements related to clinical operations - evaluating the success of programs in relation to the healthcare plan and community needs. The Committee shall make recommendations to the Board of Trustees for their approval. Marketing & Communications Committee: The minimum number of Trustees and advisory members constituting the Marketing & Communications Committee shall be three (3). The Committee shall have the responsibility for: - overseeing activities relative to branding - overseeing activities relative to informing the general public about services offered by the Corporation - overseeing activities related to government and public affairs - communicating the mission and vision of the organization - supporting advocacy and outreach activities to build visibility and support - advising and overseeing branding initiatives and managing the brand identity - reviewing and recommending the marketing and public relations plans. The Committee shall make recommendations to the Board of Trustees for their approval. Membership/Bylaws Committee: The minimum number of Trustees constituting the Membership/Bylaws Committee shall be three (3). Advisory members are prohibited from serving on the Membership/Bylaws Committee. The Committee shall have the responsibility for: - recommending a slate of officers at the first Board meeting of the calendar year, or at such other time as the Board shall determine - making recommendations to the Board throughout the year for Board members and officers to fill expiring terms and seats vacated by resignations or otherwise - coordinating the interview process for new Board candidates - coordinating the orientation of new Board members - monitoring the Board's compliance with the Bylaws and Board Governance Policies of the Corporation - making recommendations, as appropriate, for revisions to the Bylaws and Board Governance Policies - overseeing the annual board self-evaluation process and board training needs. The Committee shall make recommendations to the Board of Trustees for their approval. Audit Committee. The Audit Committee shall consist of at least three members, none of whom shall be members of the Corporation's management team, and at least two members being current Trustees. The Committee shall have responsibility for: - reviewing the proposed scope of the annual audit - recommending a firm of independent auditors to the Board to conduct the annual audit - receiving the results and recommendations of the independent auditors on completion of the annual audit - receiving and reviewing reports from the Chief Financial Officer indicating the progress being made toward the accomplishment of any recommendations made by the independent auditors - reviewing the system of internal controls and the performance of the Corporation's internal audit services and monitoring compliance by management with certain policies of the Corporation. The Committee shall make recommendations to the Budget and Finance Committee and to the Board of Trustees for their approval. FORM 990 PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S BOARD OF DIRECTORS FOR REVIEW PRIOR TO THE RETURN BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS INCLUDED IN ITS STANDARD OF CONDUCTS POLICY AND GOVERNING BYLAWS. THE PROCESS OF MONITORING COMPLIANCE WITH THIS POLICY INCLUDES PROVIDING CONFLICT OF INTEREST DISCLOSURE STATEMENTS TO EVERY EMPLOYEE, BOARD MEMBER, CONSULTANT, AND VOLUNTEER. THE DISCLOSURE STATEMENT IS REQUIRED TO BE UPDATED ANNUALLY AT THE BEGINNING OF THE YEAR. THE FOLLOWING DESCRIBES FOR THE DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AMONG DIFFERENT POSITIONS WITHIN THE ORGANIZATION. - MEMBERS OF, AND CANDIDATES FOR MEMBERSHIP ON, THE BOARD OF TRUSTEES MUST MAKE DISCLOSURES TO THE CHAIR OF THE BOARD OF TRUSTEES. IF THE CHAIR HAS AN INTEREST TO DISCLOSE, HE OR SHE MUST MAKE DISCLOSURE TO THE VICE CHAIR, RESPECTIVELY, WHO WILL, IN TURN BE RESPONSIBLE FOR ADVISING THE BOARD. - THE CEO MUST MAKE DISCLOSURES TO THE CHAIR OF THE BOARD WHO WILL, IN TURN, BE RESPONSIBLE FOR ADVISING THE BOARD OF SUCH DISCLOSURE. - STAFF ENGAGED IN THE AWARD OR ADMINISTRATION OF CONTRACTS MUST MAKE DISCLOSURES IN WRITING TO THE CEO. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED WITH A BOARD MEMBER, THE BOARD MEMBER MAY MAKE A PRESENTATION TO THE BOARD REGARDING WHETHER OR NOT HE OR SHE HAS A CONFLICT OF INTEREST, AND MAY RESPOND TO RELATED QUESTIONS FROM THE BOARD. HOWEVER, HE OR SHE SHALL LEAVE THE MEETING DURING ANY DISCUSSION OF, OR VOTING ON, WHETHER THE CONFLICT OF INTEREST EXISTS. IF SUCH CONFLICT IS DETERMINED TO EXIST, HE OR SHE SHALL LEAVE THE MEETING DURING ANY DISCUSSION OF, OR VOTING ON, THE TRANSACTION OR ARRANGEMENT THAT INVOLVES THE CONFLICT OF INTEREST. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED WITH A PERSON WHO IS NOT A BOARD MEMBER, THE CEO SHALL MAKE THE DETERMINATION. FORM 990, PART VI, SECTION B, LINE 15A & 15B EXECUTIVE COMPENSATION REVIEW: THE COMPENSATION OF THE ORGANIZATION'S CEO, OTHER OFFICERS, AND KEY EMPLOYEES WAS COMPILED BY THE HR EXECUTIVE USING NATIONAL AND LOCAL DATA FOR SALARY AND BENEFIT COMPARISON. THE HR COMMITTEE OF THE BOARD THEN REVIEWS THE SALARIES AND PROVIDES TO THE BOARD FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC FOR INSPECTION UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ ( 2,034,129) TRANSFERS TO AFFILIATE FORM 990, PART XII, LINE 2C COMMITTEE RESPONSIBLE FOR OVERSIGHT OF THE AUDIT: THE ORGANIZATION AMENDED ITS BYLAWS DURING FISCAL YEAR 2015 TO INCLUDE A CHANGE TO THE COMMITTEE THAT IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT. PLEASE SEE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, SECTION A, LINE 4. EMERALD QUARRY 1001 ROCK QUARRY RD RALEIGH NC 27610 471270222 OWN FACILITY NC 501(C)(3) 11A1 WHSI true false false false false false false false false false false false false false false false false false true false EMERALD QUARRY R 2034129 FMV