2024-05-14T15:18:34-05:00 2023-06-30 455012510 WAGNER DREESE ELSASSER & ASSOCIATES PC 1372 N SUSQUEHANNA TRL STE 210 SELINSGROVE PA 17870 990 2022-07-01 271099832 SUSQUEHANNA RIVER VALLEY DENTAL HEALTH CLINIC SUSQ 5702867500 335 MARKET STREET SUITE 1 SUNBURY PA 17801 BRIAN NEITZ CO-CHAIRMAN BOARD OF DIRECTORS 5702867500 2024-05-14 1 BRIAN NEITZ 999009999 1 ALICE M FREER CPA P00963673 5707432030 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z BRIAN NEITZ 335 MARKET ST SUITE 1 SUNBURY PA 17801 1381468 0 X SRVDHC.ORG X 2009 PA CLINIC'S MISSION IS TO PROVIDE PREVENTATIVE AND CORRECTIVE DENTAL SERVICES TO THE UNDERSERVED IN THE COMMUNITIES OF SNYDER, UNION AND NORTHUMBERLAND COUNTIES. THE CLINIC OPERATES AS A NON-PROFIT CLINIC TO MINIMIZE THE COST OF CARE TO PATIENTS BY MAINTAINING AN OPERATIONAL AND FISCALLY SOUND BUSINESS MODE. 8 7 21 11 0 0 291277 195342 1143098 1185986 33 17 0 123 1434408 1381468 0 0 0 0 1063983 937478 15000 15000 50865 456043 493822 1535026 1446300 -100618 -64832 930948 865702 4119 3705 926829 861997 X TO PROVIDE PREVENTATIVE AND CORRECTIVE DENTAL SERVICES TO THE UNDERSERVED IN THE COMMUNITIES OF SNYDER, UNION AND NORTHUMBERLAND COUNTIES. THE CLINIC OPERATES AS A NON-PROFIT TO MINIMIZE THE COST OF CARE TO PATIENTS BY MAINTAINING AN OPERATIONAL AND FISCALLY SOUND BUSINESS MODE. 0 0 1283106 1185986 DENTAL CLINIC: TO PROVIDE DENTAL HEALTH SERVICES FOR AT-RISK CHILDREN AND ADULTS, THE WORKING POOR WITH NO PRIVATE INSURANCE, AND THOSE COVERED BY MEDICAID AND MANAGED CARE PROVIDERS IN SNYDER, UNION AND NORTHUMBERLAND COUNTIES. 1283106 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 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 21 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X SUSAN WHITE 5702867500 335 MARKET STREET SUITE 1 SUNBURY PA 17801 PHILIP SOSLAND CHAIRMAN/HONORARY DIRECTOR 0.50 X X 0 0 0 BRIAN NEITZ CO-CHAIRMAN/DIRECTOR/TREASURER/ 0.75 X X 0 0 0 JOANN LAWER SECRETARY/DIRECTOR 0.75 X X 0 0 0 KAREN Y VINES DIRECTOR/CLINIC MANAGER 36.30 X X 54705 0 8426 KARL A MEYER CHAIRMAN/DIRECTOR 3.00 X X 0 0 0 NORMAN RICH DIRECTOR 0.75 X 0 0 0 IAN PROUD DIRECTOR 1.50 X 0 0 0 CATALINA A PAYSON SECRETARY/DIRECTOR 0.75 X X 0 0 0 WALTER BRUCE DIRECTOR 0.75 X 0 0 0 JULIO LARA CLINIC DENTIST 35.00 X 188061 0 764 242766 0 9190 1 0 1 0 JAMES THOMAS 335 MARKET STREET SUITE 1 SUNBURY PA 17801 DENTIST 118300 STEVEN M KREIDER 151 TANGLEWOOD LANE SUNBURY PA 17801 CONSTRUCTION 104397 2 195342 7884 195342 PATIENT FEES 621300 1120680 1120680 PATIENT FEES - MA REIM 621300 65306 65306 1185986 17 17 MISCELLANEOUS INCOME 459510 123 123 123 1381468 1185986 0 140 262167 210354 31088 20725 42577 38319 4258 490009 481196 8813 81255 70708 7996 2551 61470 53491 6049 1930 3500 3046 344 110 35611 30989 3504 1118 15000 15000 2581 2246 254 81 21529 18735 2118 676 70425 61283 6931 2211 47528 41359 4677 1492 20771 18075 2044 652 INDEPENDENT CONTRACTORS 113458 113458 DENTAL SUPPLIES 103127 103127 LAB FEES 54470 54470 CONTINUING EDUCATION 12627 12627 8195 7942 192 61 1446300 1283106 112329 50865 239208 205815 209630 126402 901357 367872 482110 533485 930948 865702 4119 3705 4119 3705 X 812716 796422 114113 65575 926829 861997 930948 865702 -64832 0 X 0 1 X 1 0 X 111702 122016 425953 291277 195342 1146290 111702 122016 425953 291277 195342 1146290 391963 754327 102 34 1335 33 17 1521 123 123 1147934 5397591 0.65710 0.66840 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2022 AMOUNT: $ 123. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 159870 179793 14 262218 77459 96391 184293 14 120828 159870 56504 167632 12 127757 96391 124323 203768 16 271579 24 56504 79284 93258 2 48216 5 124323 0.15342 0.84658 0 0 22609 22609 402168 29122 373046 41875 18547 23328 429455 318745 110710 5250 1458 3792 533485 1381468 0 1381468 0 1381468 1446300 0 1446300 0 1446300 PART V, LINE 4: PROVIDE PREVENTATIVE AND CORRECTIVE DENTAL SERVICE TO THE UNDERSERVED IN THE COMMUNITIES OF SNYDER, UNION AND NORTHUMBERLAND COUNTIES. X X 0 0 0 0 0 0 0 0 0 JULIO LARA CLINIC DENTIST 177522 0 10539 0 0 0 0 0 0 0 188061 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B ORGANIZATION'S MANAGEMENT AND MEMBERS OF THE BOARD REVIEW AND APPROVE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES, MANAGEMENT AND BOARD MEMBERS ARE SUBJECT TO A CONFLICT OF INTEREST POLICY. ONGOING MONITORING IS DONE BY THE OFFICE MANAGER AND ALL ARE REQUIRED TO NOTIFY MANAGEMENT OF ANY RELEVANT CHANGES. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR ALL EMPLOYEES IS REVIEWED AND APPROVED BY INDEPENDENT BOARD MEMBERS. ANNUAL PERFORMANCE, YEARS OF SERVICE AND REGIONAL COMPARABILITY DATA ARE ALL FACTORS CONSIDERED FOR ANNUAL PAY INCREASES AS WELL AS FOR COMPENSATION FOR NEW EMPLOYEES. THE BOARD'S REVIEW AND DECISIONS ARE DOCUMENTED IN MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST.