Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | 23017517 |
| Software Version: | 2023v5.1 |
| Return Reference | Explanation |
|---|---|
| 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. |
| Software ID: | 23017517 |
| Software Version: | 2023v5.1 |