2024-11-15T16:04:03-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2023-01-01 270052697 UNITED FAMILY PRACTICE HEALTH CENTER UNIT 6517589500 1026 WEST 7TH STREET ST PAUL MN 55102 LORI ZOOK CFO 6517589500 2024-11-14 1 0 RYAN ENGEBRETSON P01582625 6123764500 2024-11-14 2023 2024-10-15 13:58:12Z UNITED FAMILY MEDICINE DAVE THORSEN 1026 WEST 7TH STREET ST PAUL MN 55102 9424197 0 X WWW.UNITEDFAMILYMEDICINE.ORG X 2003 MN TO PROVIDE CLINICAL HEALTH, BEHAVIORAL HEALTH, DENTAL, AND SUPPORTING SERVICES AS A FQHC TO MEDICALLY UNDERSERVED AND UNDERINSURED PATIENTS. 8 8 136 9 0 0 5153281 2585339 5798377 5174794 9990 65956 705728 1064097 11667376 8890186 0 0 0 0 10189156 9449211 59734 0 547063 5074308 5099238 15323198 14548449 -3655822 -5658263 18078722 12512893 789144 818597 17289578 11694296 X UNITED FAMILY MEDICINE PROVIDES GENERAL PRACTICE PRIMARY CARE, DENTAL, AND MENTAL HEALTH SERVICES TO MEDICALLY UNINSURED AND UNDER INSURED PATIENTS. 1 0 10553754 0 6227019 UFM SERVED MORE THAN 7,800 PATIENTS WITH 26,000 VISITS IN 2023 BY OFFERING PRIMARY MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES. WE EXPANDED OUR DENTAL SERVICES TO RESPOND TO A NEED IN OUR COMMUNITY. WE CONTINUE TO TEST AND TREAT COVID-19 AND HAVE A ROBUST MENTAL HEALTH AND SUBSTANCE ABUSE PROGRAM. IN OCTOBER, WE ALSO OPENED A 340B PHARMACY THAT IS OPEN TO THE PUBLIC AS WELL AS OUR PATIENTS. 10553754 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 35 0 1 136 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X LORI ZOOK 6517589500 1026 W 7TH ST ST PAUL MN 55102 ZACK RYAN TREASURER 1.00 0.00 X X 0 0 0 KAREN GRIES PRESIDENT 1.00 0.00 X X 0 0 0 DAVID BAKER SECRETARY 1.00 0.00 X X 0 0 0 STEPHEN GUMNIT DIRECTOR 1.00 0.00 X 0 0 0 MARIA MACWILLIAMS DIRECTOR 1.00 0.00 X 0 0 0 DAYMOND DEAN DIRECTOR 1.00 0.00 X 0 0 0 CHRISTIAN PARKER DIRECTOR 1.00 0.00 X 0 0 0 ANTHONY COGNETTA DIRECTOR 1.00 0.00 X 0 0 0 ERIC BLUM FORMED CFO (LEFT APRIL 2023) 40.00 0.00 X 67307 0 12958 KEVIN O'BRIEN FORMED COO (LEFT MAY 2023) 40.00 0.00 X 46082 0 23601 LORI ZOOK CFO 40.00 0.00 X 89115 0 5614 DAVID THORSON CEO 80.00 0.00 X 126813 0 9184 CARMEL WHITE CHIEF OF STAFF 40.00 0.00 X 101534 0 15132 MARY YANG CCO 40.00 0.00 X 123244 0 23553 PHOUNG-GIANG T PHAM DDS 40.00 0.00 X 161066 0 45549 XOUA THAO MD 40.00 0.00 X 175446 0 62843 SCOTT TONGEN MD 40.00 0.00 X 210031 0 28764 BERNADETTE QUADLING CMO 32.00 0.00 X 166885 0 33626 LACY BRICK CAO 40.00 0.00 X 135866 0 40025 1403389 0 300849 8 0 1 0 DORSEY & WHITNEY 50 SOUTH 6TH ST 1500 MINNEAPOLIS MN 55402 LEGAL SERVICES 122556 NCS 7440 W 78TH ST BLOOMINGTON MN 55439 SALES SERVIES 113883 JOHN WHITINGTON 507 THOMAS DRIVE EAGLE LAKE MN 56024 IT/FACILITIES 110400 UHC SOLUTIONS 3 CENTERPOINTE DR 250 LAKE OSWEGO OR 97035 CONSULTING 106400 CLIFTONLARSONALLEN 220 SOUTH 6TH ST UNIT 300 MINNEAPOLIS MN 55402 AUDITING SERVICES 105952 5 2378518 206821 2585339 PATIENT FEE REVENUE 621110 5174794 5174794 5174794 23612 23612 576355 534011 42344 42344 42344 PHARMACY 456110 840765 840765 FUHN IHP GAIN SHARING 624100 211460 211460 MISCELLANEOUS 459900 11872 11872 1064097 8890186 6227019 0 77828 470207 254278 194336 21593 7074137 5174632 1631395 268110 59992 43170 14518 2304 1255194 903238 303757 48199 589681 424334 142703 22644 208364 149939 50424 8001 934816 624480 267836 42500 75720 54488 18324 2908 1801646 1296465 435998 69183 302557 217720 73219 11618 4943 3557 1196 190 2376 1710 575 91 48707 35050 11787 1870 632660 455262 153104 24294 97592 70227 23617 3748 EQUIPMENT AND SUPPLIES 477144 343353 115469 18322 BAD DEBT EXPENSE 473978 473978 DUES/MEMBERSHIPS/LICENS 33269 23940 8051 1278 MEALS AND ENTERTAINMENT 3523 2535 853 135 1943 1398 470 75 14548449 10553754 3447632 547063 34576 161469 5579792 189164 207178 657155 910615 37251 57137 15382559 5538579 10011632 9843980 1156343 982386 601973 160964 18078722 12512893 616500 783685 172644 34912 789144 818597 X 16232555 10637273 1057023 1057023 17289578 11694296 18078722 12512893 -5658263 62981 0 X 0 1 X 1 1 1 X 3131447 3225793 5152444 5153281 2585339 19248304 12405839 10368906 7598729 5798377 5174794 41346645 1950744 2768188 1160839 705728 1052225 7637724 17488030 16362887 13912012 11657386 8812358 68232673 3658 2903 959 1550 9070 1599286 1655669 835706 343273 814539 5248473 1602944 1658572 836665 344823 814539 5257543 62975130 84849 44917 46654 18860 23612 218892 84849 44917 46654 18860 23612 218892 11872 11872 17572879 16407804 13958666 11676246 8847842 68463437 0.91980 0.91860 0.00320 0.00260 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2023 AMOUNT: $ 11,872. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1057023 50 105326 300000 846950 1040612 16411 1057023 1040612 1040612 1015378 25234 1040612 928272 87106 1015378 1.00000 0.00000 0.00000 0 0 2464157 2464157 10996568 4673986 6322582 1087201 585219 501982 834633 279374 555259 9843980 OPERATING LEASE LIABILITY 34912 34912 X 8479189 62981 62981 8416208 473978 473978 8890186 14074471 0 14074471 473978 473978 14548449 PART V, LINE 4: THE ENDOWMENT CONSIST OF ONE FUND USED TO SUPPORT THE HEALTH CENTER. THE FUNDS ARE TO BE USED FOR BEHAVIORAL HEALTH PROGRAMMING AND EXPENSES. PART X, LINE 2: THE HEALTH CENTER QUALIFIES AS A TAX-EXEMPT CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). ACCORDINGLY, THE HEALTH CENTER IS NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE IRC. THE HEALTH CENTER IS CLASSIFIED AS A PUBLICLY SUPPORTED CHARITABLE ORGANIZATION UNDER SECTION 509(A)(2) OF THE IRC AND CONTRIBUTIONS TO THE HEALTH CENTER QUALIFY AS A CHARITABLE TAX DEDUCTION BY THE CONTRIBUTOR. THE HEALTH CENTER HAS ELECTED TO ADOPT GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE HEALTH CENTER FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 473,978. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 473,978. X X 0 0 0 0 0 0 0 0 0 SCOTT TONGEN MD 198555 0 11476 0 0 0 500 0 28264 0 238795 0 0 0 XOUA THAO MD 163608 0 11838 0 0 0 1609 0 61234 0 238289 0 0 0 PHOUNG-GIANG T PHAM DDS 157139 0 3927 0 0 0 9979 0 35570 0 206615 0 0 0 BERNADETTE QUADLING CMO 166885 0 0 0 0 0 0 0 33626 0 200511 0 0 0 LACY BRICK CAO 131035 0 4831 0 0 0 7216 0 32809 0 175891 0 0 0 FORM 990, PART III, LINE 2 OPENED A 340B PHARMACY. FORM 990, PART VI, SECTION A, LINE 1A MEMBERS OF THE COMMITTEE SHALL ACT FOR THE CORPORATION IN ALL MATTERS DURING THE INTERIM PERIODS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. ACTIONS TAKEN BY THE EXECUTIVE/FINANCE COMMITTEE SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD, AND ALL MATTERS OF MAJOR IMPORTANCE SHALL BE REFERRED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PRESENTED TO THE FINANCE COMMITTEE WHO REVIEWS IN DETAILS. IT IS PROVIDED TO ALL BOARD MEMBERS WITH FINAL APPROVAL BEING VOTED ON AT A BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS CONSISTS OF INDEPENDENT PERSONS ESTABLISHES GOALS AND OBJECTIVES FOR THE BOARD OF DIRECTORS AND ANY POTENTIAL CONFLICTS OF INTEREST THAT MAY OCCUR DURING THEIR MEMBERSHIP ON THE BOARD OF DIRECTORS. EACH YEAR, THE BOARD OF DIRECTORS REVIEWS CONFLICTS OF INTEREST WITH LEGAL COUNSEL. APPROPRIATE EDUCATION AND/OR ACTIONS ARE TAKEN BY THE BOARD AS NEEDED IN ACCORDANCE WITH THE CORPORATION'S CONFLICT OF INTEREST POLICY. BOARD MEMBERS ARE REQUIRED TO DISCLOSE AT A BOARD MEETING PREVIOUSLY UNDISCLOSED CONFLICTS AND REFRAIN FROM PARTICIPATION IN DISCUSSION OR VOTING ON THE CONFLICTING SUBJECT. KEY EMPLOYEES OF THE ORGANIZATION ARE REQUIRED TO SIGN A CONFLICT OF INTEREST DISCLOSURE ANNUALLY AS PART OF THE ORGANIZATION POLICIES FOR EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS, WHICH CONSIST OF INDEPENDENT PERSONS ESTABLISHES GOALS AND OBJECTIVES FOR THE CEO AND WITH THE ASSISTANCE OF THE HR DIRECTOR OF UFM WILL COMPILE MARKET SALARY SURVEY RESEARCH ANALYSIS AND REVIEW THIS DATA AS PART OF ONGOING CEO COMPENSATION. THIS DATA INCLUDES SOURNCES SUCH AS MNACHC SURVEY AND MN COUNCIL OF NON PROFITS FOR LIKE POSITIONS. THE BOARD, OR COMMITTEE OF THE BOARD WILL DOCUMENT FINDINGS AND ANALYSIS RELATED TO THE MARKET ANALYSIS. COMPENSATION IS REVIEWED FOR EQUITY INTERNALLY WITH HR DIRECTOR PROCESSES AND PROCEDURES. EXTERNAL COMPENSATION REVIEW IS DONE BY HR DIRECTOR USING MNACHC SURVEY, SMALL PRACTICE COMPENSATION SURVEY, AND FAIRVIEW SALARY SURVEY AS COMPENSATION RESOURCES. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2022. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVILABLE TO THE PUBLIC UPON WRITTEN REQUEST TO THE CEO OR CFO.