NATIVE AMERICAN COMMUNITY CLINIC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- NATIVE AMERICAN COMMUNITY CLINIC (EIN 03-0445789)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-11
- IRS object ID
- 202423169349302077
- Schema version
- 2023v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule J
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-11T10:43:41-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 S 6TH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030445789 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NATIVE AMERICAN COMMUNITY CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NATI | BusinessNameControlTxt |
| Phone | 6128728086 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1213 E FRANKLIN AVENUE | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554042923 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR ANTONY STATELY | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6128728086 | PhoneNum |
| Signature | 2024-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RYAN ENGEBRETSON | PreparerPersonNm |
| PTIN | P01585625 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Preparation | 2024-11-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DR ANTONY STATELY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1213 E FRANKLIN AVENUE | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554042923 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,551,119 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NACC-HEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | PROMOTE WELLNESS OF BODY, MIND & SPIRIT & REGULAR HEALTH MAINTENANCE IN NATIVE AMERICAN FAMILIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 142 | TotalEmployeeCnt |
| Total Volunteers | 19 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,288,913 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,000,663 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,000,868 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,507,001 | CYProgramServiceRevenueAmt |
| PY Investment Income | $11,124 | PYInvestmentIncomeAmt |
| CY Investment Income | $43,455 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $13,300,905 | PYTotalRevenueAmt |
| CY Total Revenue | $18,551,119 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,796,190 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,260,270 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $129,050 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $129,050 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,923,821 | PYOtherExpensesAmt |
| CY Other Expenses | $7,400,969 | CYOtherExpensesAmt |
| PY Total Expenses | $12,720,011 | PYTotalExpensesAmt |
| CY Total Expenses | $17,790,289 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $580,894 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $760,830 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,559,278 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,056,178 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,261,605 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,997,675 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,297,673 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,058,503 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROMOTE WELLNESS AND REGULAR HEALTH MAINTENANCE IN NATIVE AMERICAN FAMILIES, TO DECREASE HEALTH DISPARITY IN THE NATIVE AMERICANS IN THE METRO AREA, AND TO PROVIDE ACCESS TO QUALITY CARE REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,724,457 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $8,406,308 | RevenueAmt |
| Desc | PROVIDES MEDICAL, DENTAL, BEHAVIORAL HEALTH AND CHEMICAL HEALTH SERVICES TO NATIVE AMERICAN FAMILIES AND PATIENTS. THE ORGANIZATION HAD 24,019 VISITS DURING 2023. IN ADDITION THE ORGANIZATION PROVIDES CARE TO PATIENTS, WHO MEET CERTAIN CRITERIA UNDER THE ORGANIZATIONS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE ORGANIZATION BELIEVES THE UNDERSERVED ARE THOSE PERSONS WHO ARE UNABLE THROUGH PRIVATE RESOURCES, EMPLOYER SUPPORT OR PUBLIC AID TO PROVIDE PAYMENT FOR HEALTH CARE SERVICES OR THOSE UNABLE TO GAIN ACCESS TO HEALTH RELATED CARE BECAUSE OF LIMITED RESOURCES, INADEQUATE EDUCATION, OR DISCRIMINATION. BECAUSE THE ORGANIZATION DOES NOT PURSUE COLLECTIONS OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS REVENUE. | Desc |
| Total Program Service Expenses | $12,724,457 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 39 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 142 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNY SINGH | PersonNm |
| Phone | 6128435995 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1213 EAST FRANKLIN AVENUE | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55404 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| B DON CROFUT | |||||||
| BOARD CHAIR | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STEPHANIE GRAVES | |||||||
| BOARD VICE CHAIR | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOE BEAULIEU | |||||||
| BOARD TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CHARLA SHEFFIELD | |||||||
| BOARD SECRETARY | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LYLE IRON MOCCASIN | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT BLAKE | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD MASUR | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| LAUREN GILCHRIST | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| NICHOLE SUBOLA | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| AARON ROBINSON | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| COLLEEN MCDONALD | |||||||
| BOARD MEMBER | 0.60 | Yes (X) | $0 | $0 | $0 | ||
| KARINA FOREST | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DR KARIE RABIE | |||||||
| CMO | 40.00 | Yes (X) | $220,594 | $0 | $57,502 | ||
| DR ANTONY STATELY | |||||||
| CEO | 40.00 | Yes (X) | $222,231 | $0 | $59,604 | ||
| GREGG HARRISON | |||||||
| COO | 40.00 | Yes (X) | $127,384 | $0 | $44,444 | ||
| JENEATTA SINGH | |||||||
| FINANCE OFFICER | 40.00 | Yes (X) | $136,130 | $0 | $15,157 | ||
| SHANNON KLINGELHULTZ | |||||||
| CIO | 40.00 | Yes (X) | $109,546 | $0 | $52,205 | ||
| GAIL MASON | |||||||
| BEHAVIORAL HEALTH DIRECTOR | 40.00 | Yes (X) | $115,949 | $0 | $319 | ||
| CHRISTINE SINGER | |||||||
| MEDICAL DIRECTOR | 40.00 | Yes (X) | $147,537 | $0 | $40,361 | ||
| EMILY PIETIG | |||||||
| DENTAL DIRECTOR | 40.00 | $176,644 | $0 | $56,043 | Yes (X) | ||
| VALERIE NORRIS | |||||||
| PEDIATRICIAN | 30.00 | $129,384 | $0 | $13,385 | Yes (X) | ||
| PHONG NGUYEN | |||||||
| ADVANCED DENTAL THERAPIST | 40.00 | $122,969 | $0 | $20,225 | Yes (X) | ||
| JACE GILBERTSON | |||||||
| ASSOCIATE MEDICAL DIRECTOR OF QUAILITY | 40.00 | $107,700 | $0 | $20,636 | Yes (X) | ||
| JODI BECKER | |||||||
| ADVANCED DENTAL THERAPIST | 40.00 | $103,978 | $0 | $13,325 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,720,046 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $393,206 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| VISUALUTIONS | |||||
| 27440 MINTWOOD LANE | SPRING | TX | 77379 | FINANCIAL AND IT SOLUTIONS | $238,695 |
| ALIA | |||||
| 1000 UNIVERSITY AVE W | ST PAUL | MN | 55104 | INNOVATION SERVICES | $199,373 |
| BRIAN GORECKI REAL ESTATE CONSULTANT | |||||
| 2174 UPPER SAINT DENNIS ROAD | ST PAUL | MN | 55115 | REAL ESTATE CONSULTANT | $165,000 |
| COLLAGE | |||||
| 708 15TH AVE NE | MINNEAPOLIS | MN | 55413 | ARCHITECT | $164,319 |
| PERKINS AND WILL INC | |||||
| 410 NORTH MICHIGAN AVE SUITE 1600 | CHICAGO | IL | 60611 | ARCHITECT | $151,880 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 19 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $10,085 | FundraisingAmt |
| Government Grants | $6,264,266 | GovernmentGrantsAmt |
| All Other Contributions | $3,726,312 | AllOtherContributionsAmt |
| Noncash Contributions | $211,192 | NoncashContributionsAmt |
| Total Contributions | $10,000,663 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PATIENT REVENUES | 621400 | $8,406,308 | $8,406,308 | |
| OTHER REVENUE | 900099 | $100,693 | $100,693 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,507,001 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,455 | TotalRevenueColumnAmt |
| Exclusion | $43,455 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $10,085 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,551,119 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,406,308 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $144,148 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $931,834 | TotalAmt |
| Program Services | $465,917 | ProgramServicesAmt |
| Management And General | $465,917 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,935,634 | TotalAmt |
| Program Services | $5,337,382 | ProgramServicesAmt |
| Management And General | $1,598,252 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,490 | TotalAmt |
| Program Services | $100,887 | ProgramServicesAmt |
| Management And General | $38,603 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,659,662 | TotalAmt |
| Program Services | $1,227,746 | ProgramServicesAmt |
| Management And General | $431,916 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $593,650 | TotalAmt |
| Program Services | $436,383 | ProgramServicesAmt |
| Management And General | $157,267 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,349 | TotalAmt |
| Management And General | $26,349 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,344 | TotalAmt |
| Management And General | $49,344 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,000 | TotalAmt |
| Program Services | $38,000 | ProgramServicesAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,050 | TotalAmt |
| Fundraising | $129,050 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,182,577 | TotalAmt |
| Program Services | $2,771,225 | ProgramServicesAmt |
| Management And General | $1,411,352 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,998 | TotalAmt |
| Program Services | $677 | ProgramServicesAmt |
| Management And General | $47,321 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,834 | TotalAmt |
| Program Services | $79,804 | ProgramServicesAmt |
| Management And General | $78,030 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $379,184 | TotalAmt |
| Program Services | $234,348 | ProgramServicesAmt |
| Management And General | $144,836 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,691 | TotalAmt |
| Management And General | $2,691 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,463 | TotalAmt |
| Program Services | $180,533 | ProgramServicesAmt |
| Management And General | $42,930 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,451 | TotalAmt |
| Program Services | $13,383 | ProgramServicesAmt |
| Management And General | $8,068 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,390 | TotalAmt |
| Management And General | $12,390 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $625,411 | TotalAmt |
| Program Services | $469,058 | ProgramServicesAmt |
| Management And General | $156,353 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,886 | TotalAmt |
| Program Services | $717 | ProgramServicesAmt |
| Management And General | $52,169 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROGRAM & LAB SUPPLIES | $995,177 | $995,177 | $0 |
| MISCELLANEOUS EXPENSE | $281,351 | $242,516 | $38,835 |
| REPAIRS AND MAINTENANCE | $200,477 | $41,674 | $158,803 |
| MN CARE TAX | $81,100 | $81,100 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,286 | TotalAmt |
| Program Services | $7,930 | ProgramServicesAmt |
| Management And General | $15,356 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,790,289 | TotalAmt |
| Program Services | $12,724,457 | ProgramServicesAmt |
| Management And General | $4,936,782 | ManagementAndGeneralAmt |
| Fundraising | $129,050 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,373,726 | BOYAmt |
| EOY | $2,690,125 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,524,230 | BOYAmt |
| EOY | $1,547,268 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $334,453 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,340,605 | BOYAmt |
| EOY | $2,918,572 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,733 | BOYAmt |
| EOY | $48,653 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,985,395 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,191,174 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,794,338 | BOYAmt |
| EOY | $4,794,221 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,193 | BOYAmt |
| EOY | $57,339 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,559,278 | BOYAmt |
| EOY | $12,056,178 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,017,787 | BOYAmt |
| EOY | $956,581 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $532,258 | BOYAmt |
| EOY | $545,031 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $368,500 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250,000 | BOYAmt |
| EOY | $450,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,060 | BOYAmt |
| EOY | $46,063 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,261,605 | BOYAmt |
| EOY | $1,997,675 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,297,673 | BOYAmt |
| EOY | $10,058,503 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,297,673 | BOYAmt |
| EOY | $10,058,503 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,559,278 | BOYAmt |
| EOY | $12,056,178 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $760,830 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,322,817 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,530,356 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,875,208 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,288,913 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,010,254 | CurrentTaxYearAmt |
| Total | $38,027,548 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,322,817 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,530,356 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,875,208 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,288,913 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,010,254 | CurrentTaxYearAmt |
| Total | $38,027,548 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $1,720,426 | SubstantialContributorsTotAmt |
| Public Support Total170 | $36,307,122 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,411 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,111 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,043 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,124 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $43,455 | CurrentTaxYearAmt |
| Total | $75,144 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $38,102,692 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $25,248,875 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.95290 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99880 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $38,000 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $38,000 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LEGISLATIVE REPRESENTATION | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,935,000 | OtherCostOrOtherBasisAmt |
| Book Value | $2,935,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,236,529 | OtherCostOrOtherBasisAmt |
| Depreciation | $752,669 | DepreciationAmt |
| Book Value | $483,860 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,086,719 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,580,144 | DepreciationAmt |
| Book Value | $506,575 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,727,147 | OtherCostOrOtherBasisAmt |
| Depreciation | $858,361 | DepreciationAmt |
| Book Value | $868,786 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,794,221 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| SHORT TERM LEASE LIABILITY | $28,876 |
| LONG TERM LEASE LIABILITY | $17,187 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $46,063 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $18,551,119 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $18,551,119 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $18,551,119 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $17,790,289 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $17,790,289 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $17,790,289 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE FEDERAL INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX PROVISIONS. THE IMPLEMENTATION OF THE ACCOUNTING STANDARDS REGARDING UNCERTAIN TAX PROVISIONS HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. | ExplanationTxt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | ActivityActivityTxt | Fundraiser Control Of FundsFundraiserControlOfFundsInd | Gross ReceiptsGrossReceiptsAmt | Retained By ContractorRetainedByContractorAmt | Net To OrganizationNetToOrganizationAmt |
|---|---|---|---|---|---|---|---|---|
| J MURPHY AND ASSOCIATES RAINMAKER LLC | ||||||||
| 1300 NE GODWARD ST SUITE 2625 | MINNEAPOLIS | MN | 55413 | CAPITAL CAMPAIGN | 0 | $0 | $56,550 | -$56,550 |
| FOX ADVNACEMENT | ||||||||
| 12141 131ST STREET CT S | HASTINGS | MN | 55003 | CAPITAL CAMPAIGN | 0 | $0 | $72,500 | -$72,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $129,050 | TotalRetainedByContractorsAmt |
| Total Net To Organization | -$129,050 | TotalNetToOrganizationAmt |
| Licensed States | MN | LicensedStatesCd |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR ANTONY STATELY | ||||||||||||||
| CEO | $222,231 | $0 | $0 | $0 | $0 | $0 | $11,388 | $0 | $48,216 | $0 | $281,835 | $0 | $0 | $0 |
| DR KARIE RABIE | ||||||||||||||
| CMO | $220,594 | $0 | $0 | $0 | $0 | $0 | $5,791 | $0 | $51,711 | $0 | $278,096 | $0 | $0 | $0 |
| EMILY PIETIG | ||||||||||||||
| DENTAL DIRECTOR | $176,644 | $0 | $0 | $0 | $0 | $0 | $8,482 | $0 | $47,561 | $0 | $232,687 | $0 | $0 | $0 |
| CHRISTINE SINGER | ||||||||||||||
| MEDICAL DIRECTOR | $147,537 | $0 | $0 | $0 | $0 | $0 | $6,191 | $0 | $34,170 | $0 | $187,898 | $0 | $0 | $0 |
| GREGG HARRISON | ||||||||||||||
| COO | $127,384 | $0 | $0 | $0 | $0 | $0 | $5,925 | $0 | $38,519 | $0 | $171,828 | $0 | $0 | $0 |
| SHANNON KLINGELHULTZ | ||||||||||||||
| CIO | $109,546 | $0 | $0 | $0 | $0 | $0 | $5,551 | $0 | $46,654 | $0 | $161,751 | $0 | $0 | $0 |
| JENEATTA SINGH | ||||||||||||||
| FINANCE OFFICER | $136,130 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $15,157 | $0 | $151,287 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 309 | ContributionCnt |
| Noncash Contributions Rpt F990 | $211,192 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | PART I REPORTS THE NUMBER OF CONTRIBUTORS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE IS COMPOSED OF THE OFFICERS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE AFFAIRS, DAY TO DAY OPERATIONS AND GENERAL BUSINESS OF THIS CORPORATION. THE EXECUTIVE COMMITTEE IS AT ALL TIMES SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD OF DIRECTORS AND PROVIDES REPORTS TO THE BOARD OF DIRECTORS AT ITS REGULAR MEETINGS AND AS THE BOARD OF DIRECTORS OTHERWISE DETERMINES. IF NO CEO IS EMPLOYED, THE EXECUTIVE COMMITTEE ASSUMES THE ROLES AND RESPONSIBILITIES OF THE CEO. |
| FORM 990, PART VI, SECTION B, LINE 11B | BOTH THE MANAGEMENT AND BOARD OF DIRECTORS OF NATIVE AMERICAN COMMUNITY CLINIC REVIEWED THE FORM 990 PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS. IF A DIRECTOR HAS AN ACTUAL OR POTENTIAL CONFLICT, THEY ARE REQUIRED TO DISCLOSE THE MATERIAL FACTS TO THE BOARD OF DIRECTORS WHO DETERMINE IF A CONFLICT EXISTS. AN INTERESTED PERSON MAY NOT VOTE ON ANY MATTERS RELATED TO AN ACTUAL OR POTENTIAL CONFLICT. IN ADDITION, THE INTERESTED PERSON IS NOT COUNTED IN DETERMINING THE PRESENCE OF A QUORUM. THE MINUTES OF THE MEETING REFLECT THE DISCLOSURE MADE, THE INTERESTED PERSON'S ABSTENTION FROM VOTING, AND WHETHER A QUORUM WAS PRESENT. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOR OFFICERS, KEY EMPLOYEES AND HIGHEST PAID INDIVIDUALS, COMPENSATION WAS DETERMINED BY RESEARCHING THE RANGE OF SALARIES FOR COMPARABLE POSITIONS IN SIMILAR CLINICAL SETTINGS. COMPENSATION WAS BASED ON THE AVERAGE IN EACH SALARY RANGE. SINCE NATIVE AMERICAN COMMUNITY CLINIC IS A NOT-FOR-PROFIT ORGANIZATION, PHYSICIANS' SALARIES ARE BELOW-MARKET, BUT ARE IN LINE WITH COMPARABLE POSITIONS IN SIMILAR ORGANIZATIONS. BOARD APPROVAL FOR ALL EMPLOYEES WAS BASED ON RESEARCH FINDINGS AND NATIVE AMERICAN COMMUNITY CLINIC BUDGET ALLOWANCE. THIS RESEARCH WAS LAST PERFORMED IN 2022. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,771,225. MANAGEMENT AND GENERAL EXPENSES 1,411,352. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,182,577. |
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