2024-02-07T15:35:08-06:00 2023-06-30 221478099 COHNREZNICK LLP 350 CHURCH STREET 12TH FLOOR HARTFORD CT 06103 990 2022-07-01 931250581 WATERFALL CLINIC INC WATE 5417566232 1890 WAITE ST 1 NORTH BEND OR 97459 LANCE NELSON CEO 5417566232 2024-02-06 1 LANCE NELSON 999009999 1 LORI ROTHE YOKOBOSKY CPA P01273422 9592007000 2024-01-30 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z WATERFALL COMMUNITY HEALTH CENTER LANCE NELSON 1890 WAITE ST 1 NORTH BEND OR 97459 11751882 0 X WWW.WFALL.ORG X 1998 OR SEE SCHEDULE O 10 10 121 14 0 0 2788105 3459229 6228037 8185206 91716 -170008 20287 107447 9128145 11581874 0 0 0 0 6651779 8213376 0 0 0 2223034 2814463 8874813 11027839 253332 554035 6988257 10896364 1531413 4885485 5456844 6010879 TO PROMOTE ACCESS TO QUALITY INTEGRATED HEALTH SERVICES THAT MEET THE NEEDS OF INDIVIDUALS WITH BARRIERS TO CARE ON THE SOUTHERN OREGON COAST. 0 0 9003267 8276404 THE ORGANIZATION PROVIDED INTEGRATED HEALTH CARE SERVICES TO INDIVIDUALS WITH BARRIERS TO CARE ON THE SOUTHERN OREGON COAST. SERVICES INCLUDE MEDICAL, DENTAL, AND MENTAL HEALTH CARE. 9003267 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 14 0 1 121 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X ANDREA ZAMORA 5417566232 1890 WAITE ST 1 NORTH BEND OR 97459 ANNA HUIT DIRECTOR 1.00 X 0 0 0 ARNOLD ROBLAN DIRECTOR 1.00 X 0 0 0 DARRELL WEILAND DIRECTOR 1.00 X 0 0 0 ELIZABETH BRIGHAM SECRETARY 1.00 X X 0 0 0 LESLIE RYAN DIRECTOR 1.00 X 0 0 0 MARCE KNIGHT VICE PRESIDENT 1.00 X X 0 0 0 MCCLAIN ALTMAN DIRECTOR 1.00 X 0 0 0 ROB HILL DIRECTOR 1.00 X 0 0 0 RUTH BELL DIRECTOR 1.00 X 0 0 0 SANDRA QUALMAN PRESIDENT 1.00 X X 0 0 0 STEVE SANDEN DIRECTOR 1.00 X 0 0 0 TONY CRANE TREASURER 1.00 X X 0 0 0 ANDREA ZAMORA CFO 40.00 X 231857 0 25045 LANCE NELSON CEO 40.00 X 167338 0 11734 LORI SHOTT CLINICAL LEAD 40.00 X 137610 0 17796 LORRAINE DAVIES PSYCHIATRIST 40.00 X 380777 0 30518 MARK PASTERNAK PHYSICIAN 40.00 X 140018 0 8401 ROBERT GERBER PSYCHIATRIC PROGRAM MGR 40.00 X 127368 0 0 SHELLY PRATHER NURSE PRACTITIONER DNP 40.00 X 122000 0 9702 1306968 0 103196 9 0 1 0 0 6635 3150973 301621 3459229 CAPITATION REVENUE 624100 3237533 3237533 MANAGED CARE AND WRAPAROUND 624100 2139758 2139758 MEDICAID 624100 1401342 1401342 OTHER THIRD-PARTY PAYORS 624100 514347 514347 MEDICARE 624100 399673 399673 492553 492553 8185206 16249 0 16249 16249 16249 170008 -170008 -170008 -170008 OSOW REIMBURSEMENT 900099 88989 88989 MED RECORDS 900099 2209 2209 91198 11581874 8276404 0 -153759 471217 405508 65709 6051666 5254239 797427 203130 152347 50783 830940 623205 207735 656423 492317 164106 24961 24961 275516 275516 97218 83909 13309 28918 28918 59608 44706 14902 12432 12432 384729 290508 94221 84217 83527 690 95801 71851 23950 39715 39715 232911 181581 51330 66930 66930 SUPPLIES 825340 825340 BILLING SERVICES & SYST 350049 288281 61768 DUES & SUBSCRIPTIONS 122451 67807 54644 EQUIP RENTAL, REPAIRS & 97830 84051 13779 15837 12740 3097 11027839 9003267 2024572 0 1717864 816209 291113 788050 853369 1389211 88361 73301 5740797 1725460 4037550 4015337 0 3814256 6988257 10896364 620543 454601 329236 581634 564290 0 3866594 1531413 4885485 X 5456844 6010879 5456844 6010879 6988257 10896364 554035 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 328848 328848 4478974 1275217 3203757 745457 324791 420666 187518 125452 62066 4015337 SECURITY DEPOSITS 32365 OPERATING LEASE ASSETS 3781891 3814256 OPERATING LEASE LIABILITIES 3866594 3866594 X 11581874 0 11581874 0 11581874 11027839 0 11027839 0 11027839 PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT, AS OF JUNE 30, 2023 AND 2022, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2020 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. X X 0 0 0 0 0 0 0 0 0 LORRAINE DAVIES PSYCHIATRIST 380777 0 0 0 0 0 20500 0 10018 0 411295 0 0 0 ANDREA ZAMORA CFO 231857 0 0 0 0 0 15000 0 10045 0 256902 0 0 0 LANCE NELSON CEO 167338 0 0 0 0 0 1488 0 10246 0 179072 0 0 0 LORI SHOTT CLINICAL LEAD 137610 0 0 0 0 0 8094 0 9702 0 155406 0 0 0 FORM 990, PART I, LINE 1 TO PROMOTE ACCESS TO QUALITY INTEGRATED HEALTH SERVICES THAT MEET THE NEEDS OF INDIVIDUALS WITH BARRIERS TO CARE ON THE SOUTHERN OREGON COAST. FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATION RETURN IS PROVIDED TO THE FINANCE COMMITTEE FOR REVIEW AND RECOMMENDATION TO THE BOARD FOR APPROVAL TO FILE. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY IS DISTRIBUTED ANNUALLY AND EACH BOARD MEMBER AND OFFICER READS AND SIGNS THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 A BOARD SUB-COMMITTEE PERFORMS A REVIEW OF THE CEO AND MAKES A RECOMMENDATION TO THE BOARD REGARDING COMPENSATION UTILIZING SALARY SURVEY DATA PROVIDED BY NORTHWEST REGIONAL PRIMARY CARE ASSOCIATION AND THE OREGON PRIMARY CARE ASSOCIATION. THE CEO PERFORMS REVIEWS OF OTHER OFFICERS AND KEY EMPLOYEES AND UTILIZES THE SALARY SURVEY DATA PROVIDED BY NORTHWEST REGIONAL PRIMARY CARE ASSOCIATION AND THE OREGON PRIMARY CARE ASSOCIATION TO DETERMINE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 ANY MEMBER OF THE PUBLIC MAY REVIEW THE GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS IN THE BUSINESS OFFICE DURING NORMAL BUSINESS HOURS. FORM 990, PART IV, LINE 20: WATERFALL CLINIC, INC. IS A FEDERALLY QUALIFIED HEALTH CENTER, AND IS EXCLUDED FROM THE DEFINITION OF A GENERAL HOSPITAL. THEREFORE, THE ORGANIZATION IS NOT INCLUDING SCHEDULE H IN THE CURRENT YEAR FORM 990, AS THEY DO NOT MEET THE DEFINITION.