Form 990 for tax year 2023
Filed by THIRD STREET COMMUNITY CLINIC INC.
Totals
- Total revenue
- $22,438,116
- Total expenses
- $24,966,032
- Contributions and grants received
- $7,334,079
- Grants paid
- $0
- Program service revenue
- $15,326,819
- Investment income
- -$257,608
- Other revenue
- $34,826
- Total assets, end of year
- $18,374,674
- Total liabilities, end of year
- $6,531,413
- Net assets or fund balances, end of year
- $11,843,261
- Program services expenses (Part IX)
- $19,356,268
- Management and general expenses
- $5,609,764
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $19,356,268
Program services were 77.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Line items
Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.
Revenue
Part VIII, the statement of revenue.
-
1e · Government grants (contributions)
$6,156,566
-
1f · All other contributions, gifts and grants
$1,177,513
-
2a · Program service revenue: MEDICAID & MEDICARE REVENUE
total $2,577,638 · related or exempt $2,577,638
-
2b · Program service revenue: PATIENT SERVICES REVENUE
total $8,007,620 · related or exempt $8,007,620
-
2c · Program service revenue: PHARMACY REVENUE
total $3,955,629 · related or exempt $3,955,629
-
2d · Program service revenue: CPC INCOME
total $28,645 · related or exempt $28,645
-
2e · Program service revenue: INSURANCE INCENTIVE PAYMENTS
total $677,463 · related or exempt $677,463
-
2f · All other program service revenue
total $79,824 · related or exempt $79,824 · unrelated business $0 · excluded $0
-
3 · Investment income
total $13,812 · excluded $13,812
-
6a · Gross rents
real property $9,243
-
6b · Less rental expenses
real property $8,211
-
6c · Rental income or loss
real property $1,032 · personal property $0
-
6d · Net rental income or loss
total $1,032 · excluded $1,032
-
7a · Gross sales of assets other than inventory
securities $4,242,921
-
7b · Less cost or other basis and sales expenses
securities $4,514,341
-
7c · Gain or loss
securities -$271,420 · other assets $0
-
7d · Net gain or loss
total -$271,420 · excluded -$271,420
-
11a · Other revenue: MISCELLANEOUS REVENUE
total $33,794 · related or exempt $0 · unrelated business $0 · excluded $33,794
-
11d · All other revenue
total $0 · related or exempt $0 · unrelated business $0 · excluded $0
-
11e · Other revenue, total
$33,794
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $0 · program services $0
-
2 · Grants to domestic individuals
total $0 · program services $0
-
3 · Grants to foreign organizations and individuals
total $0 · program services $0
-
4 · Benefits paid to or for members
total $0 · program services $0
-
5 · Compensation of officers, directors and key employees
total $1,580,243 · program services $1,226,252 · management and general $353,991 · fundraising $0
-
6 · Compensation of disqualified persons
total $0 · program services $0 · management and general $0 · fundraising $0
-
7 · Other salaries and wages
total $12,723,445 · program services $9,873,258 · management and general $2,850,187 · fundraising $0
-
8 · Pension plan contributions
total $479,685 · program services $372,230 · management and general $107,455 · fundraising $0
-
9 · Other employee benefits
total $1,722,901 · program services $1,336,953 · management and general $385,948 · fundraising $0
-
10 · Payroll taxes
total $1,095,107 · program services $849,791 · management and general $245,316 · fundraising $0
-
11a · Fees: management
total $0 · program services $0 · management and general $0 · fundraising $0
-
11b · Fees: legal
total $3,452 · program services $0 · management and general $3,452 · fundraising $0
-
11c · Fees: accounting
total $18,045 · program services $0 · management and general $18,045 · fundraising $0
-
11d · Fees: lobbying
total $0 · program services $0 · management and general $0 · fundraising $0
-
11e · Fees: professional fundraising services
total $0 · fundraising $0
-
11f · Fees: investment management
total $1,407 · program services $0 · management and general $1,407 · fundraising $0
-
11g · Fees: other
total $1,294,442 · program services $801,596 · management and general $492,846 · fundraising $0
-
12 · Advertising and promotion
total $157,615 · program services $97,605 · management and general $60,010 · fundraising $0
-
13 · Office expenses
total $1,209,350 · program services $748,902 · management and general $460,448 · fundraising $0
-
14 · Information technology
total $364,879 · program services $225,955 · management and general $138,924 · fundraising $0
-
15 · Royalties
total $0 · program services $0 · management and general $0 · fundraising $0
-
16 · Occupancy
total $628,865 · program services $389,431 · management and general $239,434 · fundraising $0
-
17 · Travel
total $91,729 · program services $56,804 · management and general $34,925 · fundraising $0
-
18 · Travel or entertainment for public officials
total $0 · program services $0 · management and general $0 · fundraising $0
-
19 · Conferences, conventions and meetings
total $0 · program services $0 · management and general $0 · fundraising $0
-
20 · Interest
total $3,371 · program services $0 · management and general $3,371
-
21 · Payments to affiliates
total $0 · program services $0 · management and general $0 · fundraising $0
-
22 · Depreciation, depletion and amortization
total $459,431 · program services $444,003 · management and general $15,428 · fundraising $0
-
23 · Insurance
total $117,640 · program services $72,850 · management and general $44,790 · fundraising $0
-
24a · Other expenses: PHARMACY EXPENSE
total $2,428,372 · program services $2,428,372 · management and general $0 · fundraising $0
-
24b · Other expenses: DENTAL & MEDICAL EQUIP EXP
total $391,651 · program services $242,534 · management and general $149,117 · fundraising $0
-
24c · Other expenses: BAD DEBT EXPENSE
total $182,138 · program services $182,138 · management and general $0 · fundraising $0
-
24d · Other expenses: PATIENT BILLING EXPENSE
total $12,264 · program services $7,594 · management and general $4,670 · fundraising $0
-
24e · All other expenses
total $0 · program services $0 · management and general $0 · fundraising $0
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $996,292 · end of year $1,158,751
-
2 · Savings and temporary cash investments
beginning of year $1,254,487 · end of year $147,853
-
3 · Pledges and grants receivable
beginning of year $282,595 · end of year $2,864,470
-
4 · Accounts receivable
beginning of year $940,891 · end of year $2,779,943
-
5 · Loans and receivables from officers and key people
beginning of year $0 · end of year $0
-
6 · Loans and receivables from disqualified persons
beginning of year $0 · end of year $0
-
7 · Other notes and loans receivable
beginning of year $0 · end of year $0
-
8 · Inventories for sale or use
beginning of year $48,937 · end of year $184,858
-
9 · Prepaid expenses and deferred charges
beginning of year $93,669 · end of year $103,141
-
10a · Land, buildings and equipment: cost or other basis
$15,219,240
-
10b · Land, buildings and equipment: accumulated depreciation
$6,932,198
-
10c · Land, buildings and equipment, net
beginning of year $5,020,880 · end of year $8,287,042
-
11 · Investments: publicly traded securities
beginning of year $2,220,812 · end of year $701,463
-
12 · Investments: other securities
beginning of year $0
-
13 · Investments: program-related
beginning of year $0
-
14 · Intangible assets
beginning of year $0 · end of year $0
-
15 · Other assets
beginning of year $1,028,843 · end of year $2,147,153
-
17 · Accounts payable and accrued expenses
beginning of year $1,887,104 · end of year $3,439,627
-
18 · Grants payable
beginning of year $0 · end of year $0
-
19 · Deferred revenue
beginning of year $0 · end of year $0
-
20 · Tax-exempt bond liabilities
beginning of year $0 · end of year $0
-
21 · Escrow or custodial account liability
beginning of year $0 · end of year $0
-
22 · Loans and payables to officers and key people
beginning of year $0 · end of year $0
-
23 · Secured mortgages and notes payable
beginning of year $43,956 · end of year $911,165
-
25 · Other liabilities
beginning of year $743,241 · end of year $2,180,621
-
27 · Net assets without donor restrictions
beginning of year $9,213,105 · end of year $9,188,532
-
28 · Net assets with donor restrictions
beginning of year $0 · end of year $2,654,729
-
29 · Capital stock, trust principal or current funds
beginning of year $0 · end of year $0
-
30 · Paid-in or capital surplus, or land, building or equipment fund
beginning of year $0 · end of year $0
-
31 · Retained earnings, endowment or other funds
beginning of year $0 · end of year $0
Mission and programs · 2023
Mission
THIRD STREET COMMUNITY CLINIC (DBA THIRD STREET FAMILY HEALTH SERVICES) IS A COMMUNITY HEALTH CENTER WITH A MISSION TO DELIVER COMPREHENSIVE HEALTH AND WELLNESS CARE, ACCESSIBLE TO ALL IN THE COMMUNITIES WE SERVE IN ASHLAND, CRAWFORD, AND RICHLAND COUNTIES.
-
THIRD STREET FAMILY HEALTH SERVICES PROVIDED MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES TO A TOTAL OF 20,310 PATIENTS DURING ITS FISCAL YEAR ENDED DECEMBER 31, 2023. THESE PATIENTS MADE A TOTAL OF 17,214 VISITS TO THE CLINIC'S DENTAL FACILITY DURING 2023; 44,511 VISITS TO THE CLINIC'S MEDICAL FACILITY DURING 2023 (FOR MEDICAL AND BEHAVIORAL HEALTH SERVICES) AND 11,489 VISITS TO ITS OBSTETRIC AND GYNECOLOGY FACILITY DURING 2023. THIS INCLUDES VIRTUAL VISITS. DURING 2023, THE FILING ORGANIZATION WAS AWARDED THE AMBULATORY HEALTH CARE ACCREDITATION AND THE BEHAVORIAL HEALTH CARE ACCREDITATION, BOTH FROM THE JOINT COMMISSION, AND CONTINUE TO BE CERTIFIED. THE ORGANIZATION HAS 11 SITES.
Expenses $19,356,268 · Revenue $15,326,819
As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.
Listed in Part VII
-
ALEX GOFF
TREASURER- TERM ENDED
- Total calculated
- $0
- Hours/week
- 1
-
AMBER WERTMAN
VICE PRESIDENT / VICE CHAIR
- Total calculated
- $0
- Hours/week
- 1
-
BARRETT THOMAS
TREASURER
- Total calculated
- $0
- Hours/week
- 1
-
DOROTHY STRATTON
Secretary / Chair of Quality
- Total calculated
- $0
- Hours/week
- 1
-
JAMES DOLAN
PRESIDENT / CHAIR
- Total calculated
- $0
- Hours/week
- 1
-
ALLEN HOCKER
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
BRIGITTE COLES
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
CINDY WETTERAU
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
CODY ALBERT
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
DOUGLAS NEWSOME
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
DR JULIE CHAYA
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
DR KHUSHWANT PITTENGER
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
JALEN REESE
BOARD MEMBEER
- Total calculated
- $0
- Hours/week
- 1
-
JOE DEVANY
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
JOE STAFFORD
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
KATHY WELLS
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
MATT DAHM
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
SUSAN BAKER
BOARD MEMBER - TERM ENDED
- Total calculated
- $0
- Hours/week
- 1
-
TOM WALKER
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
VERONICA GROFF
BOARD MEMBER- TERM ENDED
- Total calculated
- $0
- Hours/week
- 1
-
BARBARA SULLINGER
CHIEF FINANCIAL OFFICER
- Total calculated
- $154,801
- From this org
- $131,864
- From related orgs
- $0
- Other
- $22,937
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $131,864
- Bonus
- $0
- Other
- $0
- Deferred
- $4,309
- Nontaxable benefits
- $18,628
- Filer's total
- $154,801
-
DR BRETT TOWARD
CHIEF MEDICAL OFFICER
- Total calculated
- $143,241
- From this org
- $123,763
- From related orgs
- $0
- Other
- $19,478
- Hours/week
- 40
-
DR DAVID HOAG
CHIEF DENTAL OFFICER
- Total calculated
- $204,865
- From this org
- $174,546
- From related orgs
- $0
- Other
- $30,319
- Hours/week
- 39
Schedule J breakdown matched by us
- Base
- $174,546
- Bonus
- $0
- Other
- $0
- Deferred
- $6,421
- Nontaxable benefits
- $23,898
- Filer's total
- $204,865
-
DR SHENG LIU
CHIEF CLINICAL OFFICER
- Total calculated
- $281,015
- From this org
- $266,382
- From related orgs
- $0
- Other
- $14,633
- Hours/week
- 32
Schedule J breakdown matched by us
- Base
- $266,382
- Bonus
- $0
- Other
- $0
- Deferred
- $6,586
- Nontaxable benefits
- $8,047
- Filer's total
- $281,015
-
JAVAR JACKSON
CHIEF OPERATING OFFICER
- Total calculated
- $222,373
- From this org
- $193,105
- From related orgs
- $0
- Other
- $29,268
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $166,583
- Bonus
- $26,522
- Other
- $0
- Deferred
- $5,370
- Nontaxable benefits
- $23,898
- Filer's total
- $222,373
-
PEGGY ANDERSON
CHIEF EXECUTIVE OFFICER
- Total calculated
- $217,752
- From this org
- $211,791
- From related orgs
- $0
- Other
- $5,961
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $183,793
- Bonus
- $27,998
- Other
- $0
- Deferred
- $5,961
- Nontaxable benefits
- $0
- Filer's total
- $217,752
-
CARLOS MOLINA ARRIOLA
PSYCHATRIST
- Total calculated
- $356,196
- From this org
- $322,961
- From related orgs
- $0
- Other
- $33,235
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $322,961
- Bonus
- $0
- Other
- $0
- Deferred
- $9,337
- Nontaxable benefits
- $23,898
- Filer's total
- $356,196
-
CAROLYN CHAMBERS
ASST CHIEF MED OFFICER / OBGYN
- Total calculated
- $322,701
- From this org
- $295,770
- From related orgs
- $0
- Other
- $26,931
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $265,979
- Bonus
- $29,791
- Other
- $0
- Deferred
- $8,057
- Nontaxable benefits
- $18,874
- Filer's total
- $322,701
-
CHEL LEES
PHYSICIAN
- Total calculated
- $195,127
- From this org
- $181,347
- From related orgs
- $0
- Other
- $13,780
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $181,347
- Bonus
- $0
- Other
- $0
- Deferred
- $5,712
- Nontaxable benefits
- $8,068
- Filer's total
- $195,127
-
JESSICA ROSE BRENT
PODIATRIST
- Total calculated
- $189,889
- From this org
- $161,799
- From related orgs
- $0
- Other
- $28,090
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $155,091
- Bonus
- $6,708
- Other
- $0
- Deferred
- $5,158
- Nontaxable benefits
- $22,932
- Filer's total
- $189,889
-
KEITH DAVIS
PHYSICIAN
- Total calculated
- $193,551
- From this org
- $167,049
- From related orgs
- $0
- Other
- $26,502
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $167,049
- Bonus
- $0
- Other
- $0
- Deferred
- $5,482
- Nontaxable benefits
- $21,020
- Filer's total
- $193,551
-
MELISSA PASKEY (VERCHIO)
PHYSICIAN
- Total calculated
- $342,098
- From this org
- $311,025
- From related orgs
- $0
- Other
- $31,073
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $281,234
- Bonus
- $29,791
- Other
- $0
- Deferred
- $8,220
- Nontaxable benefits
- $22,853
- Filer's total
- $342,098
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
- 3 · Written employment contract
- 3 · Approval by the board or compensation committee
- 4b · Supplemental nonqualified retirement plan
- 5a · Pay contingent on this organization's revenues
- 6a · Pay contingent on this organization's net earnings
Answered no
- 4a · Severance or change-of-control payment
- 4c · Equity-based compensation arrangement
- 5b · Pay contingent on a related organization's revenues
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
- THE FOLLOWING EMPLOYEES PARTICIPATED IN A 457F NONQUALIFIED EXECUTIVE DEFERRED COMPENSATION PLAN DURING 2023 AND ARE INCLUDED ON FORM 990, PART VII: PEGGY ANDERSON, JESSICA BRENT, CAROLYN CHAMBERS, DAVID HOAG, BARBARA SULLINGER, AND BRENT TOWARD. NO CONTRIBUTIONS WERE MADE TO THE PLAN BY THE ORGANIZATION FOR ANY INDIVIDUALS DURING 2023. PARTICIPANT ELIGIBILITY IS DETERMINED BY THE ORGANIZATION.
- Schedule J, Part I, Line 5a Compensation contingent on revenues of the organization
- WHILE CERTAIN BONUSES ARE NOT TIED TO REVENUE GENERATION OF THE ORGANIZATION AND ARE DESIGNED TO RECOGNIZE SUCCESS OR HARDSHIP OF THE ORGANIZATION, PROJECT, INDIVIDUAL, OR DEPARTMENT, THERE ARE BONUSES THAT ARE DETERMINED IN WHOLE OR IN PART BY THE REVENUES OF SPECIFIC ACTIVITIES. THESE BONUSES AND THE BONUSES REFERENCED IN LINE 5 ARE ADMINISTRED AT THE DISCRETION OF THE ORGANIZATION AND ARE NOT REQUIRED PURSUANT TO CONTRACTS IN-PLACE.
- Schedule J, Part I, Line 6a Compensation contingent on net earnings of the organization
- IN ADDITION TO THE BONUSES REFERENCED ON LINE 5, THERE ARE BONUSES THAT ARE CONTINGENT ON THE NET EARNINGS OF AN ACTIVITY. THESE BONUSES ARE CALCULATED AS A PERCENTAGE OF ANY REVENUES IN EXCESS OF COSTS INCURRED.
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
No itemized grants to organizations on this return.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
COMMUNITY COUNSELING ADN WELNESS CENTERS INC
501(c)(3) · HEALTHCARE SERVICES · OH · controlled entity
Directly controlled by THIRD STREET
-
COMMUNITY COUNSELING SERVICES INC
501(c)(3) · HEALTHCARE SERVICES · OH · controlled entity
Directly controlled by THIRD STREET
Provenance
- Return type
- form_990
- Tax year
- 2023
- Filed
- 15 November 2024
- IRS schema version
- 2023v5.1
- Source object
- 202403209349308345
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