2023-10-23T12:07:28-07:00 2023-06-30 990 2022-07-01 050258811 NORTHWEST COMMUNITY HEALTH CARE NORT 4015670800 PO Box 312 Pascoag RI 02859 Peter Bancroft President 4012855119 2023-10-23 1 1 11 0 AAL2 2022 2023-04-26 12:10:37Z WellOne Primary Medical and Dental Care Peter Bancroft PO Box 312 Pascoag RI 02859 29675306 0 X www.welloneri.org X 1929 RI The organization is a federally qualified health center that provides primary medical, dental, behavioral health, pharmacy and related patient support services to more than 16,000 individuals regardless of ability to pay. 13 13 188 15 0 0 4237583 6899788 21880504 22441503 -350963 289985 -8949 -5173 25758175 29626103 0 0 0 0 13540749 15630861 0 0 0 10890399 11386184 24431148 27017045 1327027 2609058 20226768 22684612 4766679 4615465 15460089 18069147 The mission of the organization is to provide primary medical, dental, behavioral health, pharmacy and related support services to the residents of the Rhode Island communities that it serves regardless of ability to pay. The emphasis is to promote the highest health status for the individual and family as well as for the community. 0 0 8950867 0 9243054 The organization provided primary medical and other patient support services to more than 11,000 individuals regardless of ability to pay. 4650742 0 3472759 The organization provided dental services to more than 6,000 individuals regardless of ability to pay. 2350727 0 1864929 The organization provided behavioral health services to approximately 1,300 individuals regardless of ability to pay. 7234172 0 10526731 The organization dispensed approximately 99,000 prescriptions through a 340(B) pharmacy program for the benefit of the organization's 16,000 patients. 7234172 0 10526731 23186508 1 1 0 0 0 0 0 0 0 0 1 0 0 0 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 9 0 1 188 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 RI X Diane Hopper 4012855137 PO Box 312 Pascoag RI 02859 Peter Bancroft President and CEO 40 0 X 266122 0 45745 Andrea Marcotte Vice President and Chief Medical Officer 40 0 X 253632 0 22103 Ryan Heney Physician and Medical Director 40 0 X 250672 0 10250 Mary Giovetti Physician 40 0 X 214294 0 44439 Dayna O'Rourke Psychiatric and Family Nurse Practitioner 40 0 X 201011 0 44047 Diane Hopper Vice President & Chief Financial Officer 40 0 X 195944 0 43558 Leonard Mannarelli Physician 40 0 X 205718 0 22929 Deirdre Norton Vice President 40 0 X 187919 0 20142 Maryam Rayani Dentist and Dental Director 40 0 X 184870 0 11421 David DeJesus Director 0.5 0 X 0 0 0 Margaret Dudley Director 0.5 0 X 0 0 0 David Ferrara Director and Secretary 0.5 0 X X 0 0 0 Joan Hilton Director 0.5 0 X 0 0 0 Sarah Nottage Director and Treasurer 0.5 0 X X 0 0 0 Christine Vallee Director 0.5 0 X 0 0 0 Crystal Leddy Director 0.5 0 X 0 0 0 Gerry Goulet Director and Chair 0.5 0 X X 0 0 0 Dennis Anderson Director and Vice Chair 0.5 0 X X 0 0 0 Darya Kravitz Director 0.5 0 X 0 0 0 Joseph Casey Director and Assistant Secretary 0.5 0 X X 0 0 0 Scott Pollard Director 0.5 0 X 0 0 0 Roberta Lacey Director 0.5 0 X 0 0 0 1960182 0 264634 32 0 1 0 CVS Health One CVS Drive Woonsocket RI 02895 Pharmacy Dispensing and Administration of 340(b) program 3950173 Blackstone Valley Community Health Care 39 East Avenue Pawtucket RI 02860 Health Information Technology 289992 Walgreen CO 200 Wilmot Road Deerfield IL 60015 Dispensing fees & pharmacy program administration 277496 MB DataSystems 837 UPPER UNION STREET SUITE C13 Franklin MA 02038 Information Technology 134411 Tom Rapoza 328 Church Street Pascoag RI 02859 Housekeeping and Maintenance 120519 5 0 0 0 0 6431574 468214 0 6899788 FQHC Services (excluding behavioral health) 621000 21125762 21125762 0 0 Behavioral health services 621420 1315741 1315741 0 0 0 0 0 0 22441503 289985 0 0 289985 0 0 0 0 0 0 0 0 44030 0 49203 0 -5173 0 -5173 0 0 -5173 0 0 0 0 29626103 22441503 0 284812 X 0 0 0 0 0 0 0 0 949415 261624 687791 0 0 0 0 0 11921757 10202085 1719672 0 396704 317232 79472 0 1446312 1105381 340931 0 916673 745216 171457 0 0 0 0 0 5148 3288 1860 0 82750 0 82750 0 0 0 0 0 0 0 0 0 0 0 4675249 4570250 104999 0 112667 106234 6433 0 436027 316763 119264 0 424403 221160 203243 0 0 0 0 0 696715 608298 88417 0 0 0 0 0 0 0 0 0 13435 13030 405 0 96072 88843 7229 0 0 0 0 0 760688 644425 116263 0 116597 81621 34976 0 Dues and licensure 38477 29387 9090 0 Telecommunications 144919 125943 18976 0 Bad debts 37309 0 37309 0 Medical supplies, labs & prescription drugs 3745728 3745728 0 0 0 0 27017045 23186508 3830537 0 1852148 1464392 5843625 9244045 662723 305933 869667 406689 0 0 0 0 409370 265947 15326022 7274054 8415307 8051968 2173928 2381392 0 0 0 0 564246 20226768 22684612 2075867 2097940 0 0 0 0 0 2690812 1946275 0 0 571250 4766679 4615465 X 14635629 16841191 824460 1227956 15460089 18069147 20226768 22684612 2609058 0 0 0 0 0 X 0 1 X 1 1 1 X 3222723 3938687 5059210 4237583 6899788 23357991 0 0 0 0 0 0 0 0 3222723 3938687 5059210 4237583 6899788 23357991 19154 23338837 127568 148915 382895 -350963 289985 598400 0 0 0 0 0 0 -66097 -59248 -83757 -8949 -5173 -223224 23733167 92142988 0.98338 0.99308 X Schedule A, Part II, Line 10 Amounts on this line include net operating results from rental of real estate (diagnostic laboratory, martial arts center, medical specialty clinics) not occupied by the organization but rented or sublicensed to parties that advance the organization's mission of promoting the highest health status for the community. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 667988 667988 0 9474537 0 9474537 0 1513112 0 1513112 0 3670385 0 3670385 0 0 7274054 -7274054 8051968 Operating lease liability 571250 571250 X 26714689 0 0 0 49203 49203 26665486 0 2960617 2960617 29626103 27066247 0 0 0 49202 49202 27017045 0 0 0 27017045 Schedule D, Part X, Line 2 The Organization has determined that there are no uncertain tax positions which qualify for either recognition or disclosure in the financial statements at June 30, 2023. Schedule D, Part XI, Line 2d Rental Income on Form 990 is reduced by Rental Expense of $49,203. Rental income included in Total Revenue, Gains and Other Support in the audited financial statements is reported at the gross amount. Schedule D, Part XI, Line 4b Total revenue on Form 990 includes capital-related grant revenue. Capital-related grants in the audited financial statements are reported below Income From Operations. Grants are recorded as revenue in the year that the grants are awarded on Form 990. Grants are recorded as revenue in the audited financial statements when such grants are expended for their permissible use and thereby are released from donor restrictions. Total revenue on Form 990 also includes employee retention credits of $2,198,532. These employee retention credits are reported below Income From Operations in the audited financial statements. Schedule D, Part XII, Line 2d Total Expenses in the audited financial statements include rental expenses. These expenses are netted against rental income on Form 990. X X X X 0 0 0 0 0 0 0 1 0 Peter Bancroft President and CEO 224495 0 15750 0 25877 0 12378 0 35912 0 314412 0 0 0 Andrea Marcotte Vice President and Chief Medical Officer 238973 0 14659 0 0 0 10250 0 12745 0 276627 0 0 0 Ryan Heney Physician and Medical Director 235185 0 13095 0 2392 0 10250 0 892 0 261814 0 0 0 Mary Giovetti Physician 208094 0 6200 0 0 0 11071 0 34188 0 259553 0 0 0 Dayna O'Rourke Psychiatric and Family Nurse Practitioner 197811 0 3200 0 0 0 10679 0 34259 0 245949 0 0 0 Diane Hopper Vice President & Chief Financial Officer 181188 0 11021 0 3735 0 10191 0 34259 0 240394 0 0 0 Leonard Mannarelli Physician 199206 0 6200 0 312 0 10414 0 13407 0 229539 0 0 0 Deirdre Norton Vice President 177871 0 10048 0 0 0 9289 0 11745 0 208953 0 0 0 Maryam Rayani Dentist and Dental Director 176807 0 5671 0 2392 0 9341 0 2972 0 197183 0 0 0 Schedule J, Part I, Line 7 The organization provides for supplemental compensation in addition to base salary in the form of performance incentive payments. These payments are awarded based on an employee's attainment of various pre-established performance criteria. The awarding of any such payments to the CEO are determined by the Board of Directors. The CEO or other members of the management team determine the performance incentive payments for other employees. Form 990, Part VI, Section A, Line 4 The organization adopted new bylaws in January 2023. Various updates were made to the bylaws including updates to the list of activities that require board authorization in accordance with the provisions of Section 330 of the Public Health Service Act. Form 990, Part VI, Section B, Line 11b A draft copy of Form 990 is distributed to all board members. The members are given the opportunity to review the document and to receive answers to questions they might have regarding same document before the document is submitted to the IRS. Form 990, Part VI, Section B, Line 12c Board members are required to disclose conflicts of interest annually through the completion of a disclosure form. Members are also required to disclose potential conflicts that may arise during the course of a meeting. If the board makes the determination that a conflict exists, the member in question may be asked to recuse his/herself from any discussion and votes regarding the matter in question. Form 990, Part VI, Section B, Line 15 The compensation and benefits of the CEO are determined by the board of directors on an annual basis. In order to inform this process, board members are provided with a myriad of comparability data from similar organizations including a review of Form 990s of other community health centers in the region and salary and benefit surveys conducted by independent organizations. The CEO establishes the compensation and benefits of other officers and key employees and utilizes the same independent data to inform this process. The compensation and benefits of other officers is shared with the board on an annual basis. The comparability study was last performed in 2021. Form 990, Part VI, Section C, Line 19 No requests were received from the public to review these documents during the year. Form 990, Part IX, Line 11g This line includes 340(b) contract pharmacy dispensing and administrative fees of $4,293,973 and assorted other clinical and nonclinical services of $381,275.