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Nonprofiteer
← REGIONAL WEST PHYSICIANS CLINIC

Form 990 for tax year 2022

Filed by REGIONAL WEST PHYSICIANS CLINIC.

Totals

Total revenue
$63,273,156
Total expenses
$74,207,157
Contributions and grants received
$21,659,200
Grants paid
$7,192
Program service revenue
$41,614,428
Investment income
-$4,766
Other revenue
$4,294
Total assets, end of year
$7,453,213
Total liabilities, end of year
$6,289,926
Net assets or fund balances, end of year
$1,163,287
Program services expenses (Part IX)
$68,050,458
Management and general expenses
$6,156,699
Fundraising expenses
$0
Program service expenses (Part III)
$68,050,458

Program services were 91.7% 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.

  • 1d · Related organizations

    $21,659,200

  • 2a · Program service revenue: PHYSICIAN SERVICES

    total $35,611,752 · related or exempt $35,611,752

  • 2b · Program service revenue: CONSULTING SERVICES

    total $5,953,167 · related or exempt $5,953,167

  • 2f · All other program service revenue

    total $49,509 · related or exempt $49,509

  • 7b · Less cost or other basis and sales expenses

    other assets $4,766

  • 7c · Gain or loss

    other assets -$4,766

  • 7d · Net gain or loss

    total -$4,766 · excluded -$4,766

  • 10a · Gross sales of inventory

    $683

  • 10b · Cost of goods sold

    $1,148

  • 10c · Net income from sales of inventory

    total -$465 · unrelated business -$465

  • 11a · Other revenue: PURCHASE DISCOUNTS

    total $4,759 · related or exempt $4,759

  • 11e · Other revenue, total

    $4,759

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $7,192 · program services $7,192

  • 5 · Compensation of officers, directors and key employees

    total $8,749,223 · program services $8,749,223

  • 6 · Compensation of disqualified persons

    total $135,333 · program services $135,333

  • 7 · Other salaries and wages

    total $24,288,493 · program services $23,351,338 · management and general $937,155

  • 8 · Pension plan contributions

    total $736,233 · program services $709,695 · management and general $26,538

  • 9 · Other employee benefits

    total $3,902,835 · program services $3,495,624 · management and general $407,211

  • 10 · Payroll taxes

    total $1,455,878 · program services $1,407,117 · management and general $48,761

  • 11c · Fees: accounting

    total $89,790 · management and general $89,790

  • 11g · Fees: other

    total $17,363,730 · program services $16,542,847 · management and general $820,883

  • 12 · Advertising and promotion

    total $5,999 · program services $5,999

  • 13 · Office expenses

    total $2,352,539 · program services $2,306,246 · management and general $46,293

  • 14 · Information technology

    total $250,664 · program services $250,664

  • 16 · Occupancy

    total $1,727,555 · program services $1,651,037 · management and general $76,518

  • 17 · Travel

    total $96,579 · program services $96,579

  • 19 · Conferences, conventions and meetings

    total $1,151 · program services $465 · management and general $686

  • 20 · Interest

    total $6,297 · program services $6,297

  • 22 · Depreciation, depletion and amortization

    total $157,984 · program services $157,733 · management and general $251

  • 23 · Insurance

    total $389,944 · program services $387,534 · management and general $2,410

  • 24a · Other expenses: CORPORATE ALLOCATION

    total $4,460,196 · program services $981,119 · management and general $3,479,077

  • 24b · Other expenses: MEDICAL EXPENSES

    total $4,454,187 · program services $4,454,075 · management and general $112

  • 24c · Other expenses: BAD DEBT EXPENSE

    total $3,219,725 · program services $3,219,725 · management and general $0

  • 24d · Other expenses: MISCELLANEOUS

    total $194,202 · program services $0 · management and general $194,202

  • 24e · All other expenses

    total $161,428 · program services $134,616 · management and general $26,812

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $10,460,658 · end of year $330,230

  • 4 · Accounts receivable

    beginning of year $6,204,857 · end of year $6,105,500

  • 8 · Inventories for sale or use

    beginning of year $483,913 · end of year $489,141

  • 9 · Prepaid expenses and deferred charges

    beginning of year $160,393 · end of year $61,285

  • 10a · Land, buildings and equipment: cost or other basis

    $3,753,742

  • 10b · Land, buildings and equipment: accumulated depreciation

    $3,341,786

  • 10c · Land, buildings and equipment, net

    beginning of year $515,534 · end of year $411,956

  • 15 · Other assets

    beginning of year $2,163,624 · end of year $55,101

  • 17 · Accounts payable and accrued expenses

    beginning of year $5,113,260 · end of year $6,152,032

  • 24 · Unsecured notes and loans payable

    beginning of year $49,462 · end of year $0

  • 25 · Other liabilities

    beginning of year $2,728,969 · end of year $137,894

  • 27 · Net assets without donor restrictions

    beginning of year $12,097,288 · end of year $1,163,287

Mission and programs · 2022

Mission

PROVIDE HEALTH CARE TO THE REGION INCLUDING THE UNDERSERVED.

  • REGIONAL WEST PHYSICIANS CLINIC IS A MULTI-SPECIALTY MEDICAL GROUP OF MORE THAN 70 PHYSICIANS AND ASSOCIATED HEALTH CARE PROVIDERS. THE CLINIC IS A PHYSICIAN-LED, PHYSICIAN-GOVERNED SUBSIDIARY OF REGIONAL WEST HEALTH SERVICES. IN THE TRADITION OF THE MAYO CLINIC AND OTHER SUCCESSFUL EXAMPLES OF PHYSICIAN HOSPITAL INTEGRATION, REGIONAL WEST PHYSICIANS CLINIC IS COMMITTED TO PROVIDING THE HIGHEST QUALITY PATIENT CARE AND SERVICE, PATIENT-DRIVEN HEALTH CARE GOVERNANCE AND LEADERSHIP, AND COMMUNITY OUTREACH TO THE REGION.

    Expenses $68,050,458 · Grants $7,192 · Revenue $41,619,187

As filed on the 2022 return.

Listed in Part VII

  • OMAR JIMENEZ MD

    PHYSICIAN

    Total calculated
    $1,439,061
    From this org
    $1,379,115
    From related orgs
    $0
    Other
    $59,946
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $1,379,115
    Bonus
    $0
    Other
    $0
    Deferred
    $11,600
    Nontaxable benefits
    $48,346
    Filer's total
    $1,439,061

  • MARK HARTMAN MD

    CHAIR

    Total calculated
    $1,046,796
    From this org
    $988,844
    From related orgs
    $0
    Other
    $57,952
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $986,522
    Bonus
    $0
    Other
    $2,322
    Deferred
    $7,597
    Nontaxable benefits
    $50,355
    Filer's total
    $1,046,796

  • ARMANDO MAGANA MD

    DIRECTOR

    Total calculated
    $999,291
    From this org
    $937,372
    From related orgs
    $0
    Other
    $61,919
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $932,181
    Bonus
    $0
    Other
    $5,191
    Deferred
    $11,600
    Nontaxable benefits
    $50,319
    Filer's total
    $999,291

  • ROMMIE HUGHES MD

    PHYSICIAN

    Total calculated
    $872,271
    From this org
    $810,316
    From related orgs
    $0
    Other
    $61,955
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $807,994
    Bonus
    $0
    Other
    $2,322
    Deferred
    $11,600
    Nontaxable benefits
    $50,355
    Filer's total
    $872,271

  • TIMOTHY FRIEDLEIN MD

    PHYSICIAN

    Total calculated
    $869,534
    From this org
    $818,154
    From related orgs
    $0
    Other
    $51,380
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $814,954
    Bonus
    $0
    Other
    $3,200
    Deferred
    $11,600
    Nontaxable benefits
    $39,780
    Filer's total
    $869,534

  • JOHN MENTGEN

    PRESIDENT/CEO THRU 10/2022

    Total calculated
    $820,525
    From this org
    $0
    From related orgs
    $695,971
    Other
    $124,554
    Hours/week
    1 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $686,629 related
    Bonus
    $0
    Other
    $0 + $9,342 related
    Deferred
    $0 + $75,199 related
    Nontaxable benefits
    $0 + $49,355 related
    Filer's total
    $0 + $820,525 related

  • SAED AWADALLAH MD

    PHYSICIAN

    Total calculated
    $773,777
    From this org
    $713,255
    From related orgs
    $0
    Other
    $60,522
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $712,769
    Bonus
    $0
    Other
    $486
    Deferred
    $11,600
    Nontaxable benefits
    $48,922
    Filer's total
    $773,777

  • JASON LATOWSKY MD

    PHYSICIAN

    Total calculated
    $769,464
    From this org
    $708,509
    From related orgs
    $0
    Other
    $60,955
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $707,969
    Bonus
    $0
    Other
    $540
    Deferred
    $11,600
    Nontaxable benefits
    $49,355
    Filer's total
    $769,464

  • JEFFREY HOLLOWAY MD

    PRESIDENT

    Total calculated
    $759,641
    From this org
    $697,686
    From related orgs
    $0
    Other
    $61,955
    Hours/week
    40 + 3 related

    Schedule J breakdown matched by us

    Base
    $695,364
    Bonus
    $0
    Other
    $2,322
    Deferred
    $11,600
    Nontaxable benefits
    $50,355
    Filer's total
    $759,641

  • BRADLEY HERTZLER MD

    DIRECTOR

    Total calculated
    $743,596
    From this org
    $682,641
    From related orgs
    $0
    Other
    $60,955
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $681,831
    Bonus
    $0
    Other
    $810
    Deferred
    $11,600
    Nontaxable benefits
    $49,355
    Filer's total
    $743,596

  • JOHN BLOMSTEDT MD

    PHYSICIAN

    Total calculated
    $724,854
    From this org
    $664,092
    From related orgs
    $0
    Other
    $60,762
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $663,451
    Bonus
    $0
    Other
    $641
    Deferred
    $11,600
    Nontaxable benefits
    $49,162
    Filer's total
    $724,854

  • RODNEY MARK SAMUELSON MD

    PHYSICIAN

    Total calculated
    $631,633
    From this org
    $596,709
    From related orgs
    $0
    Other
    $34,924
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $596,709
    Bonus
    $0
    Other
    $0
    Deferred
    $9,523
    Nontaxable benefits
    $25,401
    Filer's total
    $631,633

  • DORISA POLK MD

    DIRECTOR

    Total calculated
    $611,790
    From this org
    $552,196
    From related orgs
    $0
    Other
    $59,594
    Hours/week
    40 + 2 related

    Schedule J breakdown matched by us

    Base
    $551,298
    Bonus
    $0
    Other
    $898
    Deferred
    $11,600
    Nontaxable benefits
    $47,994
    Filer's total
    $611,790

  • SEROZAN AMROLIWALLA MD

    DIRECTOR

    Total calculated
    $608,286
    From this org
    $576,913
    From related orgs
    $0
    Other
    $31,373
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $576,662
    Bonus
    $0
    Other
    $251
    Deferred
    $11,600
    Nontaxable benefits
    $19,773
    Filer's total
    $608,286

  • TROY DEAN MD

    DIRECTOR

    Total calculated
    $557,830
    From this org
    $497,866
    From related orgs
    $0
    Other
    $59,964
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $497,817
    Bonus
    $0
    Other
    $49
    Deferred
    $11,600
    Nontaxable benefits
    $48,364
    Filer's total
    $557,830

  • KATHRYN PAINTER MD

    PHYSICIAN

    Total calculated
    $522,147
    From this org
    $461,235
    From related orgs
    $0
    Other
    $60,912
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $460,658
    Bonus
    $0
    Other
    $577
    Deferred
    $11,600
    Nontaxable benefits
    $49,312
    Filer's total
    $522,147

  • KARISSA JOHNSON MD

    PHYSICIAN

    Total calculated
    $511,635
    From this org
    $450,722
    From related orgs
    $0
    Other
    $60,913
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $450,374
    Bonus
    $0
    Other
    $348
    Deferred
    $11,600
    Nontaxable benefits
    $49,313
    Filer's total
    $511,635

  • JOSEPH MARGHEIM MD

    DIRECTOR

    Total calculated
    $452,525
    From this org
    $391,584
    From related orgs
    $0
    Other
    $60,941
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $390,849
    Bonus
    $0
    Other
    $735
    Deferred
    $11,600
    Nontaxable benefits
    $49,341
    Filer's total
    $452,525

  • MICHAEL ICKOWSKI

    TREASURER/CFO

    Total calculated
    $415,299
    From this org
    $0
    From related orgs
    $369,241
    Other
    $46,058
    Hours/week
    1 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $358,860 related
    Bonus
    $0
    Other
    $0 + $10,381 related
    Deferred
    $0 + $45,300 related
    Nontaxable benefits
    $0 + $758 related
    Filer's total
    $0 + $415,299 related

  • AMANDA VICK

    INTERIM CEO/PRESIDENT THRU 12/2022

    Total calculated
    $340,576
    From this org
    $0
    From related orgs
    $300,625
    Other
    $39,951
    Hours/week
    1 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $292,250 related
    Bonus
    $0
    Other
    $0 + $8,375 related
    Deferred
    $0 + $39,212 related
    Nontaxable benefits
    $0 + $739 related
    Filer's total
    $0 + $340,576 related

  • ELIZABETH CLEMENS

    DIRECTOR

    Total calculated
    $172,861
    From this org
    $121,243
    From related orgs
    $0
    Other
    $51,618
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $121,115
    Bonus
    $0
    Other
    $128
    Deferred
    $5,267
    Nontaxable benefits
    $46,351
    Filer's total
    $172,861

  • MARY ADAMS

    DIRECTOR

    Total calculated
    $121,086
    From this org
    $100,941
    From related orgs
    $0
    Other
    $20,145
    Hours/week
    40

  • KAYLA BARGE

    SECRETARY

    Total calculated
    $52,057
    From this org
    $0
    From related orgs
    $24,769
    Other
    $27,288
    Hours/week
    1 + 40 related

  • MEL MCNEA

    CEO/PRESIDENT

    Total calculated
    $8,654
    From this org
    $0
    From related orgs
    $8,654
    Other
    $0
    Hours/week
    1 + 45 related

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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 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)

PART I, LINE 3
THE CEO AND CFO ARE COMPENSATED BY REGIONAL WEST HEALTH SERVICES, A RELATED ORGANIZATION. METHODS USED TO ESTABLISH COMPENSATION FOR THESE INDIVIDUALS INCLUDE THE FOLLOWING: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B
THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: JOHN MENTGEN 64,199 MICHAEL ICKOWSKI 33,700 AMANDA VICK 27,612

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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2022
Filed
14 November 2023
IRS schema version
2022v5.0
Source object
202333189349305513

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