2024-11-15T16:51:06-08:00 2023-12-31 541283622 Larry D Sturgill CPA PC PO Box 2080 WISE VA 24293 990 2023-01-01 043739083 ST MARYS HEALTH WAGON INC STMA 2763288850 PO BOX 7070 WISE VA 24293 TERESA TYSON President & CEO 2024-10-14 true true LARRY D STURGILL P00381273 2763289593 2023 2024-10-15 13:58:12Z PO BOX 7070 WISE VA 24293 6270539 false X THEHEALTHWAGON.ORG X 2004 VA In the heart of the Appalachian Mountains, a bold mission unfolds. St. Marys Health Wagon (the Health Wagon), a dedicated non-profit, tirelessly works to break down barriers to healthcare for underserved and vulnerable communities in central Appalachia. More than a mission, the Health Wagon is leading a healthcare accessibility revolution with dedication that is unyielding and resolve that is unwavering. The Health Wagon has operated for over 40 years as a transformational healthcare provider in Southwest Virginia, bridging the severe healthcare access gaps in one of the nations most economically and medically underserved areas. Our mission is to bring accessible, quality healthcare to the medically underserved in Central Appalachia. The Health Wagon addresses acute and chronic health needs while simultaneously working to alleviate the socioeconomic barriers that undermine health outcomes. The Health Wagon stands poised to revolutionize heath care access. The Health Wagon stands as a r 7 7 72 10 0 9871333 5310399 71545 78471 -729397 881669 0 9213481 6270539 0 0 4012224 3988661 12500 0 433945 2889347 2455507 6914071 6444168 2299410 -173629 18140608 18036379 218767 288167 17921841 17748212 St. Marys Health Wagons mission is to provide compassionate, quality health care to the medically underserved in Central Appalachia. The Health Wagon is dedicated to delivering high-quality healthcare to underserved and remote communities, breaking down barriers to access through innovative mobile medical services as well as offering services at stationary clinics as well. With a commitment to empowering individuals and families, the Health Wagon brings essential care directly to those in need, ensuring that geography, income, or resources are never obstacles to health and well-being. The Health Wagons ideal is to foster healthier, more resilient communities by connecting people to comprehensive, patient-centered care, all while maintaining a steadfast focus on excellence, empathy, innovation and accessibility. false false 5418244 ***See Client Notes*** 5418244 true true false false false true false false false false true false false true true false true false false false false false false false false false false false false true false false false false false false false false true false false false false true false true false true 0 0 false 72 true false false false false false false false 0 false false false false false false false X 7 7 false false false false false false false true true false false true true true true true true true true false VA X X TERESA TYSON 2763288850 5626 PATRIOT DRIVE WISE VA 24293 X TERESA TYSON DNPFNP-BCFAANP CEO, PRESIDENT 65.00 8.00 299147 0 0 PAULA COLLINS DNPFNP-BCFAANP PPCNP-C,V.P/CLINCIAL DIRECTOR 65.00 8.00 299061 0 0 OLIVIA STALLARD DDS DENTIST 45.00 0.00 198391 0 0 ETHAN COLLINS MSENFNP-BC GRANT MANAGER 45.00 16.00 128174 63438 0 CARA A ROBINSON FNP-BC COMPLIANCE MGR 45.00 0.00 184877 0 0 CHRISTOHER J RATLIFF FNP-BC NURSE PRACTIONER 45.00 0.00 122570 0 0 JAZLYN ROWE FNP-BC NURSE PRACTIONER 45.00 0.00 119562 0 0 VALERIE STEWART FNP-BC Vice Chair 1.00 1.00 X X 0 0 0 CATHY HAWKINS Director 1.00 0.00 X 0 0 0 MARK HANDY MD Director 1.00 0.00 X 0 0 0 CHARLES KISER Director 1.00 0.00 X 0 0 0 FARON COUCH Director 1.00 0.00 X 0 0 0 JERRY STANLEY Director 1.00 0.00 X 0 0 0 SHEILAH COLLINS Treasurer 1.00 0.00 X X 0 0 0 MARTHA MCCARROLL Director 1.00 0.00 X 0 0 0 SHIRLEY WOODWARD Secretary 1.00 0.00 X X 0 0 0 STEVE SMITH Chairman 1.00 0.00 X X 0 0 0 JOSEPH F SMIDDY MD BOARD EMERITUS 6.00 0.00 X 0 0 0 1351782 63438 7 false true false 0 763953 4546446 331743 5310399 MEDICAL FEE'S 78471 78471 78471 881669 881669 0 0 0 0 0 0 0 0 6270539 78471 881669 0 0 0 0 598208 317934 280274 0 2591286 2411164 180122 227087 198156 11787 17144 339139 288929 25559 24651 232941 209019 9741 14181 0 475 475 78385 78385 0 0 97907 97907 27010 27010 5192 5192 91064 83116 3736 4212 225074 202566 11254 11254 0 0 52449 46964 2209 3276 0 0 0 0 451435 428863 22572 123428 111086 6171 6171 OUTREACH 365501 365501 PATIENT SERVICE EXPENSE 355750 355750 PUBLIC RELATIONS 163344 163344 RAM EXPENSE 142746 142746 275747 256450 14899 4398 6444168 5418244 591979 433945 3264348 2857143 0 0 78156 80928 0 0 0 98838 0 0 6850528 1336148 5815024 5514380 8554004 8261125 0 0 0 330238 1322803 18140608 18036379 18236 17660 200531 270507 218767 288167 X 16326987 17520073 1594854 228139 17921841 17748212 18140608 18036379 -173629 X true X true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 124000 false false 93000 93000 3755404 312850 3442554 217383 48887 168496 1623793 408792 1215001 1160948 565619 595329 5514380 Building-Construction In Progress 429553 DUE FROM ACEH 266768 Due From Others 451930 INTRAFUNDS RECEIVABLES 59124 NOTE RECEIVABLE ACEH 100000 PREPAID EXPENSES 15426 Rounding 2 1322803 ACCRUED COMPENSATED ABSENCES 84410 INTERFUND PAYABLE 59124 PAYROLL WITHHOLDINGS 843 SALARIES PAYABLE 126130 270507 6270539 6270539 6270539 6444168 6444168 6444168 X false false false false false false false false false CARA A ROBINSON FNP-BC COMPLIANCE MGR 171682 13195 184877 ETHAN COLLINS MSENFNP-BC GRANT MANAGER 109766 63438 18408 128174 63438 OLIVIA STALLARD DDS DENTIST 197343 1048 198391 PAULA COLLINS DNPFNP-BCFAANP PPCNP-C,V.P/CLINCIAL DIRECTOR 288821 10240 299061 TERESA TYSON DNPFNP-BCFAANP CEO, PRESIDENT 288907 10240 299147 X 153461 FMV X 1 35000 NADA VALUE X 2 143282 false false false Form 990, Part VI, Section B, Line 11b The reviewing of Form 990 typically involves a structured, collaborative process that engages key stakeholders to ensure compliance, transparency, and alignment with the organizations mission. The process begins with the CPA, Larry Sturgill, preparing the initial draft of Form 990 based on the nonprofits financial records. He conducts a detailed review to ensure accuracy in revenue, expenses, grants, and program accomplishments. Health Wagons financial liaison to Larry Sturgill, CPA then performs a line-by-line review of the draft, verifying financial accuracy, compliance with IRS requirements, and consistency with prior filings.Next, the President and CEO and other executive leadership reviews the narrative sections to ensure they effectively highlight the nonprofits mission, impact, and program accomplishments. Input is provided on significant achievements to be featured under program services descriptions. The finance committee, including board members with financial expertise, reviews the document to evaluate the portrayal of financial health and alignment with board-approved budgets and financial reports.The Form 990 is presented to the Board of Trustees for oversight. This step encourages board members to ask questions and understand key aspects of the filing, including governance disclosures and compliance issues. The review and approval process is documented in meeting minutes to demonstrate board oversight. Feedback from the board and other stakeholders is addressed collaboratively by the CPA, financial liaison, and finance committee, with all corrections and clarifications incorporated into the final document. A vote is tendered to accept the 990 in final form. Once all parties are satisfied, the CEO signs off on Form 990, and the CPA files it with the IRS by the appropriate deadline. Post-filing, the organization shares the filed Form 990 with the Board of Trustees and makes it publicly accessible, reinforcing transparency. A copy is given to individual Board of Trustee members as well. Finally, a post-filing debrief with the finance committee and CPA helps identify lessons learned and opportunities to advance the process for the following year. Additionally, internal and external financial audits that are independently contracted are conducted annually. This approach ensures comprehensive oversight and strengthens trust among donors, stakeholders, and the public. Form 990, Part VI, Section B, Line 12c The Health Wagon conducts annual board training, including periodic training on The Health Wagons conflict of interest policy, the annual disclosures required, and the process for review and approval of any related party transactions. The Executive committee of the Board of Trustees, with the assistance of general counsel, oversees the submission of the annual disclosures by the directors, officers, trustees, and key employees, reviews the disclosures to determine whether there are interests that could give rise to conflicts, and monitors overall compliance with the policy. If any actual or potential conflicts were to arise, the general counsel would work with the Executive Committee, the Board of Trustees, and management, as appropriate, to facilitate the assessment of the fairness of the deliberations or voting regarding the transaction and otherwise monitor compliance with the policy. The Health Wagon has a conflict of interest statement and trustees are asked to sign annually. In connection with any actual or possible conflict of interest, any trustees, officer, key employee or member of a committee with the governing board must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the Board of Trustees and/or members of the committee considering the proposed transactions, initiatives, or arrangements. Each Board of Trustee shall annually sign a statement which affirms such person:a.Has received a copy of the conflict of interest policy,b.Has read and understands the conflict of interest policy, c.Has agreed to comply with the conflict of interest policyInterested persons shall disclose or update their interests that may have conflicting interests, family members or other business dealings. This can include any type of transactions or affiliations with businesses arising from any family members or their dealings.To ensure The Heath Wagon continues to operate in a manner that is consistent with charitable purposes and does not engage in activities that could jeopardize its tax-exempt status, periodic and consistent reviews yearly will be done. It will entail a.Whether compensation arrangement and benefits are reasonable.b.If joint partnerships and ventures are consistent with The Health Wagons written policies and procedures. That they are properly recorded, include reasonable investment or payment for goods and services, further charitable purposes and do not result in inurement, impermissible private benefit or in an excess benefit transaction.c.Whether the Board of Trustees and all of those committed to The Health Wagons cause are properly implementing this conflict interest of interest policy.d.Whether any improvements should be made to this conflict of interest policy.When complying with this conflict of interest policy the Health Wagon may, but not need, use outside counsel and if indeed they are used their use shall not relieve the board of trustees of its responsibility under this conflict of interest policy.If the Board of Directors determines that there is a conflict of interest it shall adhere to the following procedures:a.The chairperson of the board shall appoint someone that is not of interest to investigate the proposed transaction or arrangement.b.After exercising due diligence, the Board of Trustees shall make a determination whether the Health Wagon can obtain with reasonable efforts a more advantageous transaction or arrangement from a person or entity that would not give rise to a conflict of interest.If a more advantageous transaction or arrangement is not reasonably possible under circumstances not producing a conflict of interest, the board of directors will make a determination by a majority vote of the disinterested board members only whether to continue with said transactions. Form 990, Part VI, Section B, Line 15a The Health Wagons CEO compensation review and approval process is designed to ensure fairness, competitiveness, and alignment with the organizations advancement of mission and objectives. At the Health Wagon, the Board of Trustees understand the importance of fair and objective compensation for our executive team. Our compensation packages are designed to attract and retain top-tier talent while ensuring that our leaders are fairly compensated for their critical roles in advancing our mission and serving the Appalachian region. Furthermore, the Board of Trustees considers chief executive leadership pay one of the most mission-critical responsibilities under its purview.The Health Wagons CEO compensation review and approval process uses best practices guidelines, and balances organizational objectives while maintaining transparency and accountability. The Board of Trustees with assistance from a designated committee such as the Executive Committee or Personal Committee, conducts a review of the CEO's compensation. This process begins with a formal evaluation of the CEOs performance, focusing on accomplishments in meeting organizational goals, financial stewardship, and strategic priorities that are looked at year-round with detailed reports to the Board. To determine appropriate compensation, the committee conducts a comprehensive market analysis, utilizing data sources, including the GuideStar Nonprofit Compensation Report. This data reinforces the commitment to accountability and sustainability within nonprofit leadership. Impact and program advancement are also heavily considered and weighed. In determining compensation, the Board considers factors such as education level, with a doctoral-prepared nurse practitioner at the helm, tenure (31 years with the organization), industry standards, job functions, organizational performance, understanding of the organizations unique role in providing critical healthcare services to underserved populations and the complexities of the modern post-pandemic healthcare landscape including workforce shortages and healthcare wage increases, and ensures that compensation reflects these realities while remaining competitive at both local and national levels.Although The Health Wagon is a nonprofit, it must compete for talent in the for-profit arena. While widely recognized as a free and charitable clinic, the Health Wagon functions similarly to or even beyond that of a Federally Qualified Health Center (FQHC) due to its robust programmatic activities. Even most FQHC dont deliver the depth and breadth of services that the Health Wagon offers. The organization operates two stationary clinics, a state-of-the-art dental clinic, four mobile units, an after-hours clinic, and provides 24-hour call services. It offers comprehensive primary and preventive care, specialty services, vision, tele-radiology, mental health services, social outreach support, and mass outreach events, managing five divisions with 76 programs aimed at enhancing regional health and well-being in Central Appalachia. The CEOs salary reflects the scope of responsibilities, the organizations impact, and the skills required to navigate challenges in a complex healthcare delivery environment. Sustainable development in nonprofit organizations often necessitates competitive compensation for leaders who drive innovation, manage complex systems, and secure funding for life-saving programs. At The Health Wagon, this leadership has enabled groundbreaking advances in healthcare access for Central Appalachia.The Health Wagon furthermore acknowledges and appreciates the dedication of its executives, who often work extreme hours to address significant healthcare challenges. Both the CEO/President and Vice President/Clinical Director are doctoral-prepared nurse practitioners who balance administrative responsibilities with patient care and the management of a 24-hour on-call medical services. Their roles effectively equate to holding two full-time jobsan intentional cost-saving measure for the organization. They have earned national and international recognition, speaking before the World Health Organization (WHO) and the United Nations and have elevated the Health Wagon to a national and international platform. Under the visionary leadership of CEO/President Vice President/Clinical Director, the Health Wagon has developed a new model of health care delivery, the Integrative Comprehensive Collaborative Collective (ICCC) Model. This model stands to transform healthcare by integrating multidisciplinary teams, advanced telehealth technologies, leverage innovation and utilize community partnerships. By emphasizing collaboration across various sectors, the Health Wagon has addressed systemic inequities and delivered tailored care to remote and underserved populations. These accomplishments underscore the importance of sustaining their leadership through fair and equitable compensation while ensuring the organizations long-term viability. The Health Wagons integrative model serves as a beacon for sustainable, collaborative healthcare, proving that innovation and leveraging valuable resources can coexist in the nonprofit sector.The CEO/President oversees the salaries of all other employees, benchmarking them against comparable positions within the healthcare sector to ensure competitiveness and fairness. This process considers individual contributions, responsibilities, performance metrics, and their strategic impact on the Health Wagons success. Annual appraisals are conducted, and detailed reports on staff and organizational management are available to the Board, which reviews finances and approves the budget. Through this rigorous and transparent approach, the Health Wagon demonstrates its commitment to responsible governance and its mission to serve the Appalachian region. Form 990, Part VI, Section B, Line 15b The Health Wagon purchases a widely used independent compensation survey published by Guidestars Nonprofit Compensation Guide. The President and CEO and/or Personnel Committee performs an annual evaluation and compensation review of key employees. The most recent compensation review occurred in 2023. Form 990, Part VI, Section C, Line 19 Governing Documents Disclosure Explanation Summary: The Health Wagons governing documents, conflict of interest policy, and form 990s are available to the public upon request by emailing drtysonnp@thhealthwagon.org. The organization's annual reports and annual financial statements are available online at www.thehealthwagon.org. 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