2024-01-19T10:10:27-06:00 2023-06-30 231909723 MCKONLY & ASBURY LLP 415 FALLOWFIELD ROAD CAMP HILL PA 17011 990 2022-07-01 208979596 SUSQUEHANNA COMMUNITY HEALTH AND DENTAL CLINIC INC SUSQ 5705675400 471 HEPBURN STREET WILLIAMSPORT PA 17701 MAX HOUSEKNECHT JR CFO 5705675400 2024-01-19 1 MAX HOUSEKNECHT JR 999009999 1 GARY J DUBAS P00252339 7177617910 2024-01-19 X 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z RIVER VALLEY HEALTH & DENTAL CLINIC JAMES YOXTHEIMER 471 HEPBURN STREET WILLIAMSPORT PA 17701 16762827 0 X WWW.RIVERVALLEYHEALTHANDDENTAL.ORG X 2007 PA TO EXTEND GOD'S HEALING BY PROVIDING INCLUSIVE, QUALITY PRIMARY MEDICAL AND DENTAL CARE. 12 12 140 11 691 0 4775087 4791742 10172881 11862595 2072 29798 698260 63307 15648300 16747442 0 0 0 0 8994020 8823885 0 0 0 5857258 6362306 14851278 15186191 797022 1561251 8760131 13254080 5067565 8000263 3692566 5253817 X THE ORGANIZATION'S MISSION IS TO EXTEND GOD'S HEALING BY PROVIDING INCLUSIVE, QUALITY PRIMARY MEDICAL AND DENTAL CARE TO ALL THOSE WHO NEED IT. LOCATED IN THE CENTER OF WILLIAMSPORT, PENNSYLVANIA, WE SERVE THE RESIDENTS OF THE GREATER RIVER VALLEY COMMUNITY WITH COMPREHENSIVE PRIMARY CARE (MEDICAL AND DENTAL) INCLUDING SPECIALIZED SERVICES FOR BEHAVIORAL AND REPRODUCTIVE HEALTH. 0 0 8115209 6703687 PRIMARY HEALTH CARE: WE PROVIDE COMPREHENSIVE PRIMARY CARE SERVICES REGARDLESS OF ABILITY TO PAY. OUR SERVICES INCLUDE SOCIAL WORK, DIRECTLY; AND BEHAVIORAL HEALTH, SUBSTANCE ABUSE, EMERGENCY, CHIROPRACTIC SERVICES, AND SPECIALTY CARE THROUGH REFERRAL RELATIONSHIPS. WE ACCEPT MEDICAID, MEDICARE, PRIVATE INSURANCE, AND HAVE A SLIDING FEE SCALE BASED ON FAMILY INCOME FORTHOSE WITHOUT INSURANCE. WE ARE THE ONLY PRIMARY CARE PROVIDER AND LYCOMING COUNTYTHATISACCEPTING PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. WE ARE A COMMUNITYBASED ORGANIZATIONWORKING WITH OTHERS TO INCREASE ACCESS FOR THE UNDERINSURED AND UNINSURED. 4295025 4595586 DENTAL CARE:WE PROVIDE PREVENTIVE AND RESTORATIVE DENTISTRY INCLUDING CLEANINGS SEALANTS, AND EXTRACTIONS. WE GO THE EXTRA MILE TO HELP OUR PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. WE HAVE A CHILDREN'S READINESS PROGRAM AND ARE BUILDING A COMMUNITY DENTAL EDUCATION PROGRAM. WE ALSO HAVE A DENTAL OUTREACH PROGRAM THAT GOES TO SCHOOLS AND OTHER COMMUNITY EVENTS TO PROVIDE ONSITE DENTAL CARE FOR CHILDREN. WE DO OUR BEST TO GET THOSE SUFFERING FROM PAIN IN TO BE SEEN THE SAME DAY. WE ARE THE ONLY DENTAL CLINIC IN LYCOMING COUNTY AND ARE ACCEPTING NEW PATIENTS. WE ARE A COMMUNITYBASED ORGANIZATION WORKING WITH OTHERS TO INCREASE ACCESS FOR THE UNDERINSURED AND UNINSURED. 12410234 1 0 0 1 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 1 0 0 0 0 0 0 0 0 0 0 0 1 41 0 140 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X MAX HOUSEKNECHT JR CFO 5705675418 471 HEPBURN STREET WILLIAMSPORT PA 17701 KIMBERLY WETHERHOLD CHAIRPERSON 1.00 X X 0 0 0 JEAN MYERS VICE CHAIRPERSON 1.00 X X 0 0 0 CHRISTOPHER EBNER SECRETARY 1.00 X X 0 0 0 DR RALPH KAISER BOARD TREASURER 1.00 X X 0 0 0 ABIGAIL ESCHBACH DIRECTOR 1.00 X 0 0 0 SHANTAY HALL DIRECTOR 1.00 X 0 0 0 MARK THOMPSON DIRECTOR 1.00 X 0 0 0 BARB VANASKIE DIRECTOR 1.00 X 0 0 0 PASTOR VELINDA WEBB SMITH DIRECTOR 1.00 X 0 0 0 JOSHUA WARFEL DIRECTOR 1.00 X 0 0 0 AUSTIN WHITE DIRECTOR 1.00 X 0 0 0 DR KAYLA RICHARDSON CHIEF MEDICAL OFFICER (TERM 8/22) 40.00 X 253596 0 14217 JAMES YOXTHEIMER PRESIDENT/CEO 40.00 X 183007 0 11181 MAX HOUSEKNECHT JR CHIEF FINANCIAL OFFICER 40.00 X 104358 0 10376 MATTHEW MCLAUGHLIN CHIEF OPERATING OFFICER 40.00 X 103291 0 0 DANIEL CONNER PHYSICIAN 40.00 X 306600 0 21360 STEVEN LEUNG PHYSICIAN 40.00 X 254225 0 10933 WILLIAM BARTLOW PHYSICIAN (START 8/22) 40.00 X 244559 0 23748 DANIEL BOZZA DENTIST 40.00 X 203688 0 24334 PATRICIA BOZZA DENTIST 40.00 X 186700 0 2244 1840024 0 118393 9 0 1 0 ECLINICALWORKS PO BOX 847950 BOSTON MA 02284 IT SUPPORT SERVICES 350594 CARDINAL HEALTH PHARMACY SOLUTIONS 21377 NETWORK PLACE CHICAGO IL 60673 PHARMACY MANAGEMENT 344396 CORNERSTONE SERVICES CORP 14460 FALLS OF NEUSE RD SUITE 149-3 RALEIGH NC 27614 HEALTH SERVICES 232563 HOPE ENTERPRISES 2401 REACH ROAD WILLIAMSPORT PA 17701 CLEANING SERVICES 125983 INSIGHT MEDICAL GROUP PO BOX 392798 PITTSBURGH PA 15251 BEHAVIORAL HEALTH SERVICES 103297 5 4785487 6255 4791742 NET PATIENT SERVICE 621400 11299273 11299273 340B PHARMACY PROGRAM REVENUE 621400 563322 563322 11862595 33901 33901 12310 11282 1028 1028 691 337 4103 -4103 -4103 -4103 OTHER REVENUE 900099 62279 62279 62279 16747442 11862595 691 92414 658795 554703 104092 6279389 5287224 992165 74913 59586 15327 1810788 1442092 368696 8406 6707 1699 68203 54417 13786 1326463 1058290 268173 153849 122751 31098 182343 145485 36858 740385 590726 149659 397798 308583 89215 51088 40761 10327 191624 152763 38861 777981 620133 157848 99130 79092 20038 SUPPLIES 1084715 865454 219261 304B SUPPLIES 705336 562761 142575 REPAIRS AND MAINTANENCE 224639 179177 45462 STAFF RECRUITMENT 178291 142252 36039 172055 137277 34778 15186191 12410234 2775957 0 1844116 720631 732614 2840849 276615 288063 621074 752781 120431 372802 4627853 2197173 5165281 2430680 0 5848274 8760131 13254080 1492018 1928643 117504 37293 155151 779240 3302892 5255087 5067565 8000263 X 3692566 5253817 3692566 5253817 8760131 13254080 1561251 0 X X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 1250 1250 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO THE PENNSYLVANIA ASSOCIATION OF COMMUNITY HEALTH CENTERS. A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING PURPOSES. 225424 18849 206575 1329634 474755 854879 683946 414362 269584 2388849 1289207 1099642 2430680 ROU ASSET - OPERATING LEASE 1086826 ROU ASSET - FINANCE LEASE 3295037 CIP 1466411 5848274 FINANCE AND CAPITAL LEASE OBLIGATIONS 4169665 OPERATING LEASE OBLIGATIONS 1085422 5255087 X 16581730 11282 11282 16570448 176994 176994 16747442 15020479 11282 11282 15009197 176994 176994 15186191 PART X, LINE 2: THE CENTER IS EXEMPT FROM FEDERAL INCOME TAX ON RELATED EXEMPT FUNCTION ACTIVITIES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). MANAGEMENT BELIEVES THE CENTER CONTINUES TO BE OPERATED IN SUCH A MANNER THAT IT IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. THEREFORE, THERE IS NO SUCH PROVISION FOR INCOME TAXES. THE CENTER ADHERES TO THE PROVISIONS OF FASB ASC 740, INCOME TAXES. ASC 740 ESTABLISHES RULES FOR RECOGNIZING AND MEASURING TAX POSITIONS TAKEN IN AN INCOME TAX RETURN, INCLUDING DISCLOSURES OF UNCERTAIN TAX POSITIONS (UTPS). ASC 740 MANDATES THAT COMPANIES EVALUATE ALL MATERIAL INCOME TAX POSITIONS FOR PERIODS THAT REMAIN OPEN UNDER APPLICABLE STATUTES OF LIMITATION, AS WELL AS POSITIONS EXPECTED TO BE TAKEN IN FUTURE RETURNS. THE UTP RULES THEN IMPOSE A RECOGNITION THRESHOLD ON EACH TAX POSITION. AN ORGANIZATION CAN RECOGNIZE AN INCOME TAX BENEFIT ONLY IF THE POSITION HAS A "MORE LIKELY THAN NOT" (I.E., MORE THAN 50 PERCENT) CHANCE OF BEING SUSTAINED ON THE TECHNICAL MERITS. FOR THE YEARS ENDED JUNE 30, 2023 AND 2022, THE CENTER HAS TAKEN NO MATERIAL TAX POSITIONS ON ITS APPLICABLE TAX FILINGS THAT DO NOT MEET THE MORE LIKELY THAN NOT THRESHOLD. AS A RESULT, NO AMOUNT FOR UTPS HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2020. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 11,282. PART XI, LINE 4B - OTHER ADJUSTMENTS: 304B ADMIN FEES 176,994. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 11,282. PART XII, LINE 4B - OTHER ADJUSTMENTS: 304B ADMIN FEES 176,994. X X X 0 0 0 0 0 0 0 1 0 DANIEL CONNER PHYSICIAN 272919 0 33681 0 0 0 1500 0 19860 0 327960 0 0 0 WILLIAM BARTLOW PHYSICIAN (START 8/22) 234559 0 10000 0 0 0 1500 0 22248 0 268307 0 0 0 DR KAYLA RICHARDSON CHIEF MEDICAL OFFICER (TERM 8/22) 232365 0 21231 0 0 0 0 0 14217 0 267813 0 0 0 STEVEN LEUNG PHYSICIAN 252275 0 1950 0 0 0 0 0 10933 0 265158 0 0 0 DANIEL BOZZA DENTIST 193688 0 10000 0 0 0 1500 0 22834 0 228022 0 0 0 JAMES YOXTHEIMER PRESIDENT/CEO 183007 0 0 0 0 0 1500 0 9681 0 194188 0 0 0 PATRICIA BOZZA DENTIST 186700 0 0 0 0 0 1500 0 744 0 188944 0 0 0 PART I, LINE 7 BONUSES WERE PROVIDED THIS YEAR FOR ADDITIONAL WORK RELATED TO THE CONTINUED COVID PANDEMIC. ANGELA HOUSEKENCHT MOTHER OF CFO 48674 SALARY 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CFO. ONCE APPROVED, THE FORM 990 IS SENT TO THE PRESIDENT/CEO FOR REVIEW AND APPROVAL. THE PRESIDENT/CEO WILL THEN FORWARD A COPY OF THE FORM 990 TO THE BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE POTENTIONAL CONFLICTS OF INTEREST. ALL CONFLICTS ARE REVIEWED AT THE BOARD LEVEL. WHEN A POTENTIAL CONFLICT IS IDENTIFIED,AND THE FULL BOARD DETERMINES THAT A CONFLICT OR THE APPEARANCE OF A CONFLICT IS PRESENT, THE INDIVIDUAL IS EXCUSED FROM DELIBERATION AND DECISION MAKING. FORM 990, PART VI, SECTION B, LINE 15 REVIEW OF THE PRESIDENT/CEOS COMPENSATION IS PERFORMED ON AN ANNUAL BASIS. THE ORGANIZATION HAS A THIRD PARTY (R ELLEN K RAJEWSKI) CONDUCT A THOROUGH STUDY OF EXECUTIVE COMPENSATION UTILIZING NATIONAL, STATE, AND REGIONAL COMPENSATION DATA TO DEVELOP A RECOMMENDATION OF A COMPETITIVE, FAIR, AND EQUITABLE SALARY RANGE FOR THE CEO. THE BOARD THEN REVIEWS THE RECOMMENDATION AND COMPENSATES ACCORDINGLY. THE REVIEW IS DOCUMENTED IN THE MINUTES. REVIEW OF OTHER EXECUTIVE SALARIES IS COMPLETED BY BENCHMARKING DATA FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE DEPARTMENT OF LABOR BY THE BOARD OF DIRECTORS. THIS REVIEW IS DOCUMENTED IN THE MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE EXECUTIVE/FINANCE COMMITTEE OF THE BOARD