St Marys Health Wagon Inc

“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.”

“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.”

“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-t”

“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.”

“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 [email protected]. The organization's annual reports and annual financial statements are available online at www.thehealthwagon.org.”