FURP.ORG / PUBLIC DATA EXPLORER

COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC (EIN 42-1527584)
Tax period
2020-03-01 to 2021-02-28
Filed
2022-02-16
IRS object ID
202220479349300332
Schema version
2020v4.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-02-16T10:32:34-06:00ReturnTs
Tax Period End2021-02-28TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-03-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421527584EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWABusinessNameLine1Txt
Business Name Line2INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
In Care Of% ANTONIO FLORESInCareOfNm
Business Name ControlCOMMBusinessNameControlTxt
Phone3197532300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11706 W AGENCY ROADAddressLine1Txt
CityWEST BURLINGTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52655ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANTONIO FLORESPersonNm
Person TitleCHIEF EXECUTIVE OFFIPersonTitleTxt
Phone3197532300PhoneNum
Signature2021-07-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstANTONIOPersonFirstNm
Person LastFLORESPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKrystal K CreachPreparerPersonNm
PTINP01248198PTIN
Phone4178658701PhoneNum
Preparation2022-01-25PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerANTONIO FLORESPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11706 W AGENCY ROADAddressLine1Txt
CityWEST BURLINGTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52655ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$24,245,930GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressCHCSEIA.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2001FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionCHCSEIA PROVIDES COMPREHENSIVE HEALTH SERVICES, GENERAL DENTISTRY AND COMMUNITY HEALTH PROGRAMS, AND OTHER HEALTH CARE SERVICES TO RESIDENTS OF THE SE IOWA REGION.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee185TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,299,706PYContributionsGrantsAmt
CY Contributions Grants$5,415,566CYContributionsGrantsAmt
PY Program Service Revenue$16,860,003PYProgramServiceRevenueAmt
CY Program Service Revenue$18,635,495CYProgramServiceRevenueAmt
PY Investment Income$32,223PYInvestmentIncomeAmt
CY Investment Income$46,878CYInvestmentIncomeAmt
PY Other Revenue$47,953PYOtherRevenueAmt
CY Other Revenue$133,336CYOtherRevenueAmt
PY Total Revenue$20,239,885PYTotalRevenueAmt
CY Total Revenue$24,231,275CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,825,941PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,947,394CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,184,005PYOtherExpensesAmt
CY Other Expenses$6,843,788CYOtherExpensesAmt
PY Total Expenses$18,009,946PYTotalExpensesAmt
CY Total Expenses$20,791,182CYTotalExpensesAmt
PY Revenues Less Expenses$2,229,939PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,440,093CYRevenuesLessExpensesAmt
Total Assets BOY$15,621,410TotalAssetsBOYAmt
Total Assets EOY$22,692,992TotalAssetsEOYAmt
Total Liabilities BOY$3,948,105TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,579,594TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,673,305NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$15,113,398NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE PRIMARY HEALTH CARE TO RESIDENTS OF THE GREATER SE IOWA REGION, ESPECIALLY THOSE INDIVIDUALS/FAMILIES WITH LIMITED RESOURCES OR WITH OTHER BARRIERS TO HEALTH CARE. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$14,088,119ExpenseAmt
Revenue$18,635,495RevenueAmt
DescCOMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA PROVIDES SEVERAL HEALTH SERVICES TO THE COMMUNITY, INCLUDING: COMPREHENSIVE HEALTH SERVICES WITH A VARIETY OF PHYSICIAN SPECIALTIES, GENERAL DENTISTRY AND COMMUNITY HEALTH PROGRAMS INVOLVING ORAL HEALTH EDUCATION AND DENTAL SCREENING, FAMILY PLANNING, HEALTH SCREENINGS, IMMUNIZATIONS, CASE MANAGEMENT, AND PHARMACIES. DURING THE FISCAL YEAR, THE HEALTH CENTERS HAD APPROXIMATELY 17,400 DENTAL VISITS AND 40,200 MEDICAL VISITS (INCLUDES BEHAVIORAL HEALTH).Desc
Total Program Service Expenses$14,088,119TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document34IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee185EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonANTONIO FLORESPersonNm
Phone3197532300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11706 WEST AGENCY ROADAddressLine1Txt
CityWEST BURLINGTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52655ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
ERIC BOYUM
PSYCHIATRIST40.00.0Yes (X)$292,151$0$35,722
SHAILESH DESAI
PHYSICIAN40.00.0Yes (X)$259,706$0$40,583
LUCAS LEMBURG
CDO40.00.0$222,058$0$39,269Yes (X)
JOHN BRADY
CMO30.00.0$244,518$0$11,642Yes (X)
TESSA JOHNSON
DENTIST40.00.0Yes (X)$185,178$0$36,524
MARK STROPE
PHYSICIAN40.00.0Yes (X)$195,679$0$23,839
CATHERINE HANSEN
PHYSICIAN40.00.0Yes (X)$185,870$0$22,882
DIANE ROUSE
CFO40.00.0$134,823$0$34,833Yes (X)
RONALD KEMP
CEO40.00.0$143,475$0$21,814Yes (X)
ANTONIO FLORES
COO40.00.0$135,435$0$13,620Yes (X)
ANGELICA CARDENAS
DIRECTOR BEG 05/20201.00.0$0$0$0Yes (X)
BARRY CORSON
TREASURER1.00.0$0$0$0Yes (X)Yes (X)
BILL STAATS
VICE CHAIR1.00.0$0$0$0Yes (X)Yes (X)
CHUCK GRIFFITH
DIRECTOR1.00.0$0$0$0Yes (X)
DAVID WHITAKER
DIRECTOR1.00.0$0$0$0Yes (X)
DENISE OSBORN
DIRECTOR1.00.0$0$0$0Yes (X)
JASON STRANDBERG
CHAIR1.00.0$0$0$0Yes (X)Yes (X)
JEFF STRAUSE
DIRECTOR1.00.0$0$0$0Yes (X)
JULIE SCHILLING
SECRETARY1.00.0$0$0$0Yes (X)Yes (X)
CINDY SHARPE
DIRECTOR1.00.0$0$0$0Yes (X)
SUE SORENSEN
DIRECTOR BEG 06/20201.00.0$0$0$0Yes (X)
JOANNA SCHNEDEN
DIRECTOR BEG 11/20201.00.0$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,998,893TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$280,728TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K28IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PAIN CENTERS OF IOWA
5515 UTICA RIDGE ROAD 600DAVENPORTIA52807HEALTH SERVICES$350,320
NEXTGEN
1811 VON KARMAN AVE STE 800IRVINECA92612SOFTWARE SUPPORT$252,420
BKD LLP
910 E ST LOUIS SUITE 200SPRINGFIELDMO658011190AUDIT & CONSULT SERV$108,355
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Government Grants$5,151,945GovernmentGrantsAmt
All Other Contributions$263,621AllOtherContributionsAmt
Noncash Contributions$3,682NoncashContributionsAmt
Total Contributions$5,415,566TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE624100$18,559,977$18,559,977
OTHER REVENUE624100$75,518$75,518
FieldValueIRS element (for citing)
Total Program Service Revenue$18,635,495TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$61,533TotalRevenueColumnAmt
Exclusion$61,533ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$14,655OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$14,655OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$14,655TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescGAIN ON INV IN EQUITY INVESTEEDesc
Business900099BusinessCd
Total Revenue Column$133,336TotalRevenueColumnAmt
Exclusion$133,336ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$133,336OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,231,275TotalRevenueColumnAmt
Related Or Exempt Func Income$18,635,495RelatedOrExemptFuncIncomeAmt
Exclusion$194,869ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,001,487TotalAmt
Program Services$517,487ProgramServicesAmt
Management And General$484,000ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,291,953TotalAmt
Program Services$7,171,539ProgramServicesAmt
Management And General$3,120,414ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$401,088TotalAmt
Program Services$270,827ProgramServicesAmt
Management And General$130,261ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,495,015TotalAmt
Program Services$921,045ProgramServicesAmt
Management And General$573,970ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$757,851TotalAmt
Program Services$509,400ProgramServicesAmt
Management And General$248,451ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$45,197TotalAmt
Management And General$45,197ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$82,182TotalAmt
Management And General$82,182ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,358,537TotalAmt
Program Services$1,984,197ProgramServicesAmt
Management And General$374,340ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$12,781TotalAmt
Program Services$2,390ProgramServicesAmt
Management And General$10,391ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,071,999TotalAmt
Program Services$411,399ProgramServicesAmt
Management And General$660,600ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$355,221TotalAmt
Program Services$10,002ProgramServicesAmt
Management And General$345,219ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$31,456TotalAmt
Program Services$7,477ProgramServicesAmt
Management And General$23,979ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$31,724TotalAmt
Program Services$24,190ProgramServicesAmt
Management And General$7,534ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$112,912TotalAmt
Program Services$3,150ProgramServicesAmt
Management And General$109,762ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$507,808TotalAmt
Program Services$172,425ProgramServicesAmt
Management And General$335,383ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$97,431TotalAmt
Program Services$43,044ProgramServicesAmt
Management And General$54,387ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$1,910,440$1,909,840$600
LICENSES, DUES, SUBSCRIPTIONS$123,576$43,259$80,317
RECRUITING & RETENTION$102,524$86,448$16,076
REPAIRS AND MAINTENANCE$0

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$20,791,182TotalAmt
Program Services$14,088,119ProgramServicesAmt
Management And General$6,703,063ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$257,126BOYAmt
EOY$80,211EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,454,379BOYAmt
EOY$4,492,765EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$62,284BOYAmt
EOY$2,382,493EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,687,340BOYAmt
EOY$2,307,688EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$201,589BOYAmt
EOY$386,999EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$71,370BOYAmt
EOY$279,162EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,598,421LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,388,044LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,311,625BOYAmt
EOY$7,210,377EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$173,326BOYAmt
EOY$306,662EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$644,435EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,402,371BOYAmt
EOY$4,602,200EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$15,621,410BOYAmt
EOY$22,692,992EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,190,095BOYAmt
EOY$2,317,995EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,162,595BOYAmt
EOY$2,045,850EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$2,419,607EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$595,415BOYAmt
EOY$796,142EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,948,105BOYAmt
EOY$7,579,594EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,520,810BOYAmt
EOY$15,113,398EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$152,495BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,673,305BOYAmt
EOY$15,113,398EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,621,410BOYAmt
EOY$22,692,992EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,440,093ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,708,922CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,916,957CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,213,276CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,299,706CurrentTaxYearMinus1YearAmt
Current Tax Year$5,415,566CurrentTaxYearAmt
Total$18,554,427TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,708,922CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,916,957CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,213,276CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,299,706CurrentTaxYearMinus1YearAmt
Current Tax Year$5,415,566CurrentTaxYearAmt
Total$18,554,427TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$18,554,427PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,600CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,053CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,069CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$28,523CurrentTaxYearMinus1YearAmt
Current Tax Year$61,533CurrentTaxYearAmt
Total$103,778TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$18,658,205TotalSupportAmt
Gross Receipts Rltd Activities$72,853,126GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99444PublicSupportCY170Pct
Public Support PY1700.99710PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1(I)FormAndLineReferenceDesc
ExplanationOTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC), THE IOWA PRIMARY CARE ASSOCIATION (IAPCA), AND THE ILLINOIS PRIMARY HEALTHCARE ASSOCIATION (ILPHCA). A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$223,943OtherCostOrOtherBasisAmt
Book Value$223,943BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,230,540OtherCostOrOtherBasisAmt
Depreciation$2,308,459DepreciationAmt
Book Value$5,922,081BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$505,753OtherCostOrOtherBasisAmt
Depreciation$236,620DepreciationAmt
Book Value$269,133BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,012,269OtherCostOrOtherBasisAmt
Depreciation$1,285,335DepreciationAmt
Book Value$726,934BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$625,916OtherCostOrOtherBasisAmt
Depreciation$557,630DepreciationAmt
Book Value$68,286BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,210,377TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
DUE FROM THIRD PARTY PAYERS$3,500,000
OTHER RECEIVABLES$306,058
457(B) ASSETS$796,142
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,602,200TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED COMPENSATIONDesc
Amt$796,142Amt
FieldValueIRS element (for citing)
Total Liability$796,142TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$24,281,674TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$35,744DonatedServicesAndUseFcltsAmt
Revenue Not Reported$35,744RevenueNotReportedAmt
Revenue Subtotal$24,245,930RevenueSubtotalAmt
Other Revenues Not Included-$14,655OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$14,655RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$24,231,275TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,841,581TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$35,744DonatedServicesUseFcltsAmt
Other Expenses Included$14,655OtherExpensesIncludedAmt
Expenses Not Reported$50,399ExpensesNotReportedAmt
Expenses Subtotal$20,791,182ExpensesSubtotalAmt
Total Expenses Per Form990$20,791,182TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: ($ 14,655) LOSS ON SALE OF EQUIPMENT
SCHEDULE D, PART XII, LINE 2DAMOUNTS INCLUDED ON LINE 1, BUT NOT ON PART FORM 990, PART IX, LINE 25: $ 14,655 LOSS ON SALE OF EQUIPMENT

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RONALD KEMP
CEO$140,858$0$0$0$2,617$0$7,273$0$14,541$0$165,289$0$0$0
DIANE ROUSE
CFO$127,467$0$0$0$7,356$0$6,697$0$28,136$0$169,656$0$0$0
ERIC BOYUM
PSYCHIATRIST$282,151$0$10,000$0$0$0$8,362$0$27,360$0$327,873$0$0$0
SHAILESH DESAI
PHYSICIAN$249,706$0$10,000$0$0$0$13,244$0$27,339$0$300,289$0$0$0
MARK STROPE
PHYSICIAN$188,658$0$7,021$0$0$0$9,942$0$13,897$0$219,518$0$0$0
CATHERINE HANSEN
PHYSICIAN$175,870$0$10,000$0$0$0$0$0$22,882$0$208,752$0$0$0
TESSA JOHNSON
DENTIST$174,623$0$10,555$0$0$0$9,548$0$26,976$0$221,702$0$0$0
JOHN BRADY
CMO$232,839$0$0$0$11,679$0$11,642$0$0$0$256,160$0$0$0
LUCAS LEMBURG
CDO$210,248$0$11,810$0$0$0$11,369$0$27,900$0$261,327$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1AHEALTH OR SOCIAL CLUB DUES: THE ORGANIZATION OFFERS A WELLNESS PROGRAM TO ITS EMPLOYEES WHICH PROVIDES DIRECT REIMBURSEMENT OF UP TO $25 PER MONTH AFTER THE EMPLOYEES HAVE USED THE GYM OR WEIGHT WATCHERS PROGRAM THREE TIMES DURING THE MONTH. EMPLOYEE MUST SHOW DOCUMENTATION OF PAYMENT OF FEES AND ATTENDANCE. IF ATTENDANCE IS LESS THAN THREE TIMES A MONTH, NO PAYMENT IS MADE.
SCHEDULE J, PART I, LINE 7NON-FIXED PAYMENTS: BONUS AMOUNTS PAID ARE BASED ON PRODUCTION LEVELS AND QUALITY MEASURES

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 6VOLUNTEERS: THE ORGANIZATION'S BOARD OF DIRECTORS IS A VOLUNTEER BOARD.
FORM 990, PART III, LINE 1ORGANIZATION'S MISSION: CHCSEIA IS A FEDERALLY QUALIFIED HEALTH CENTER WHOSE MISSION IS TO PROVIDE AFFORDABLE, COMPREHENSIVE, CULTURALLY APPROPRIATE, COST EFFECTIVE HEALTH CARE TO RESIDENTS OF THE GREATER SOUTHEASTERN IOWA REGION IN ORDER TO IMPROVE THEIR OVERALL HEALTH STATUS. THE MAIN PURPOSES OF THE ORGANIZATION ARE THE FOLLOWING: -PROVIDE PRIMARY MEDICAL CARE, GENERAL DENTAL SERVICES, AND INTEGRATED BEHAVIORAL HEALTH SERVICES -CREATE NEW HEALTH CARE RESOURCES AND HEALTH CA ARRANGEMENTS TO OFFER TO THE COMMUNITIES SERVED BY THE CORPORATION -EXPAND ACCESS TO HEALTH CARE TO THOSE INDIVIDUALS UNABLE TO OBTAIN ADEQUATE HEALTH CARE -REDUCE UNNECESSARY DUPLICATION OF SERVICES, TECHNOLO AND FACILITIES BY COORDINATING THE DELIVERY OF HEALTH CARE SERVICES ON A COST-EFFECTIVE BASIS -CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED OR THE PROMOTION OR HEALTH WHICH MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS OR OTHER REQUIREMENTS THAT ARE OR CAN BE MADE AVAILABLE -PROMOTE AND CARRY ON SPECIAL RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED INSOFAR AS SAID RESEARCH CAN BE CARRIED ON, OR IN CONNECTION WITH, THE FACILITIES AND PROGRAMS OPERATED BY THIS CORPORATION -TAKE AND HOLD BY BEQUEST, DEVISE, GIFT, GRANT, PURCHASE, LEASE OR OTHERWISE ANY PROPERTY, REAL, PERSONAL, TANGIBLE OR INTANGIBLE, OR ANY UNDIVIDED INTEREST THEREIN, WITHOUT LIMITATION AS TO AMOUNT OR VALUE -SELL, CONVEY OR TO OTHER DISPOSE OF ANY SAID PROPERTY AND INVEST, REINVEST, OR DEAL WITH THE PRINCIPAL OR THE INCOME THEREOF IN SAID MANNER AS, IN THE JUDGEMENT OF THE DIRECTORS OF THIS CORPORATION, WILL BEST PROMOTE THE PURPOSES OF THE CORPORATION WITHOUT LIMITATION, EXCEPT SUCH LIMITATIONS, IF ANY AS MAY BE CONTAINED IN THE INCORPORATION, THE BYLAWS OF THE CORPORATION, OR ANY OTHER LAWS THERETO APPLICABLE. -RAISE GIFTS, BEQUESTS, DONATIONS, AND OTHER FUNDS FROM THE PUBLIC AND FROM ALL OTHER SOURCES AVAILABLE, RECEIVE AND MAINTAIN SUCH FUNDS AND EXPEND PRINCIPAL AND INCOME THERE FROM IN SUPPORT OF OR IN FURTHERANCE OF THE CHARITABLE PURPOSES OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO BEING FILED, THE RETURN IS REVIEWED BY THE ORGANIZATION'S CEO AND CFO. IT IS THEN PROVIDED TO THE BOARD FOR APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST POLICY: A. GENERAL PRINCIPLES PROHIBITING CONFLICTS: NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR MEMBER OF THE BOARD OF DIRECTORS OF CHC/SEIA WILL PARTICIPATE IN THE SELECTION, AWARD, OR ADMINISTRATION OF A CONTRACT OR GRANT (SUPPORTED BY FEDERAL FUNDS) IF A REAL OR APPARENT CONFLICT OF INTEREST WOULD BE INVOLVED. SUCH A CONFLICT WOULD ARISE WHEN THE EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR BOARD MEMBER, OR ANY MEMBER OF HIS OR HER IMMEDIATE FAMILY, HIS OR HER PARTNER, OR AN ORGANIZATION WHICH EMPLOYS OR IS ABOUT TO EMPLOY ANY OF THE PARTIES INDICATED HEREIN, HAS A FINANCIAL OR OTHER INTEREST IN THE FIRM SELECTED FOR THE CONTRACT OR AWARD. B. CONFLICTS OF INTEREST AND DISCLOSURE REQUIREMENTS: NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR BOARD MEMBER WILL HAVE A DIRECT OR INDIRECT FINANCIAL INTEREST IN, OR RECEIVE ANY COMPENSATION OR OTHER BENEFITS AS A RESULT OF, TRANSACTIONS BETWEEN CHC/SEIA AND ANY INDIVIDUAL OR BUSINESS FIRM WITHOUT DISCLOSING THE CONFLICT OF INTEREST. NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER, OR MEMBER OF THE BOARD OF DIRECTORS MAY PARTICIPATE IN THE SELECTION, AWARD, OR ADMINISTRATION OF A CONTRACT OR GRANT IN WHICH FEDERAL FUNDS ARE USED, IF THEY HAVE A FINANCIAL OR OTHER INTEREST IN THE FIRM SELECTED FOR THE CONTRACT OR AWARD WITHOUT DISCLOSING THE CONFLICT OF INTEREST. IF AN EMPLOYEE, CONTRACTOR, AGENT, OFFICER, OR MEMBER OF THE BOARD OF DIRECTORS BELIEVES THAT ONE OF THE AFOREMENTIONED CONFLICTS ACTUALLY OR POTENTIALLY EXISTS, HE OR SHE MUST IMMEDIATELY DISCLOSE THIS INFORMATION IN WRITING TO THE CEO. DISCLOSURES BY MEMBERS OF THE BOARD OF DIRECTORS MUST ALSO BE MADE TO THE CHAIR OF THE BOARD OF DIRECTORS (AND IF IT IS THE CEO OR THE CHAIR WHO HAS SUCH A FINANCIAL INTEREST, HE OR SHE MUST MAKE DISCLOSURE TO THE CHAIR OR VICE CHAIR, RESPECTIVELY). THE CHC/SEIA REQUIRES THAT ALL EMPLOYEES, CONTRACTORS, AGENTS, OFFICERS AND MEMBERS OF THE BOARD OF DIRECTORS AND CANDIDATES FOR BOARD MEMBERSHIP DISCLOSE IN WRITING (AND UPDATE AT LEAST ANNUALLY) AT OR AROUND THEIR JANUARY MEETING: - ALL BUSINESS AND FAMILY RELATIONSHIPS WHICH CREATE AN ACTUAL OR POTENTIAL A CONFLICT OF INTEREST, AND - WHERE APPLICABLE, PROVIDE A STATEMENT SUGGESTING HOW SUCH CONFLICT COULD BE AVOIDED OR MITIGATED. TO FACILITATE DISCLOSURE, CHC/SEIA REQUIRES EMPLOYEES, CONTRACTORS, AGENTS) OFFICERS AND BOARD MEMBERS TO COMPLETE A CHC/SEIA CONFLICT OF INTEREST FORM. COMPLETION THE FORM DOES NOT RELIEVE INDIVIDUALS OF THE OBLIGATION TO NOTIFY THE CEO OR BOARD CHAIR IF CHANGES OCCUR SINCE FILING OF THE FORM REGARDING A NEW CONFLICT OF INTEREST. NO MEMBER OF THE BOARD OF DIRECTORS MAY VOTE ON ANY MATTER WHICH MAY DIRECTLY OR INDIRECTLY RESULT IN FINANCIAL OR OTHER GAIN TO THAT MEMBER, OR WHICH MAY CONFLICT WITH THAT MEMBER'S OBLIGATIONS TO ANOTHER ORGANIZATION'S BOARD OF DIRECTORS OR TO HIS OR HER EMPLOYER. PROVIDED THAT THE MEMBER OF THE BOARD OF DIRECTORS HAS FIRST DISCLOSED A CONFLICT OR POTENTIAL CONFLICT, AND ABSTAINS FROM VOTING IN THAT REGARD, HE OR SHE MAY PARTICIPATE IN DISCUSSIONS RELATING TO THAT MATTER.
FORM 990, PART VI, SECTION B, LINE 15ACOMPENSATION REVIEW: ANNUALLY PAY RANGES ARE REVIEWED AS PART OF THE BUDGETING PROCESS. COMPARABILITY DATA IS USED FROM FQHC SALARY SURVEY RESULTS FROM NACHC, IOWA PRIMARY CARE ASSOCIATION AND ILLINOIS PRIMARY CARE ASSOCIATION. IOWA WORKFORCE DEVELOPMENT SURVEY RESULTS FOR THE REGION ARE ALSO COMPARED. ANY PROPOSED CHANGES ARE TAKEN TO CHCSEIA'S PERSONNEL COMMITTEE, FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 15BCOMPENSATION REVIEW: ANNUALLY PAY RANGES ARE REVIEWED AS PART OF THE BUDGETING PROCESS. COMPARABILITY DATA IS USED FROM FQHC SALARY SURVEY RESULTS FROM NACHC, IOWA PRIMARY CARE ASSOCIATION AND ILLINOIS PRIMARY CARE ASSOCIATION. IOWA WORKFORCE DEVELOPMENT SURVEY RESULTS FOR THE REGION ARE ALSO COMPARED. ANY PROPOSED CHANGES ARE TAKEN TO CHCSEIA'S PERSONNEL COMMITTEE, FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC EXCEPT IN CASES WHERE IT IS REQUIRED BY LAW. FINANCIAL STATEMENTS ARE ONLY RELEASED FOR ACTIVITIES THAT ARE DEEMED NECESSARY FOR BONA FIDE BUSINESS PURPOSES, SUCH AS LOANS, OR IN CASES WHERE IT IS REQUIRED BY LAW.
FORM 990 PART IX LINE 11GDESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1052931
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACT SERVICES TOTAL FEES:424892
FORM 990 PART IX LINE 11GDESCRIPTION:HIT EXPENSE TOTAL FEES:347058
FORM 990 PART IX LINE 11GDESCRIPTION:OTHER CONTRACTUAL FEES TOTAL FEES:324151
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING FEES TOTAL FEES:177291
FORM 990 PART IX LINE 11GDESCRIPTION:INTERPRETOR SERVICES TOTAL FEES:32214