FURP.ORG / PUBLIC DATA EXPLORER

SIOUXLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
SIOUXLAND COMMUNITY HEALTH CENTER (EIN 42-1374894)
Tax period
2020-02-01 to 2021-01-31
Filed
2021-11-22
IRS object ID
202103269349301450
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)
Return2021-11-22T16:31:01-06:00ReturnTs
Tax Period End2021-01-31TaxPeriodEndDt

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 Begin2020-02-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421374894EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SIOUXLAND COMMUNITY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JAN ANDERSON CFOInCareOfNm
Business Name ControlSIOUBusinessNameControlTxt
Phone7122522477PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11021 NEBRASKA STAddressLine1Txt
CitySIOUX CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51105ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARI KAPTAIN-EAHLENPersonNm
Person TitleCEOPersonTitleTxt
Phone7122522477PhoneNum
Signature2021-11-01SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMARIPersonFirstNm
Person LastKAPTAIN-EAHLENPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKrystal K CreachPreparerPersonNm
PTINP01248198PTIN
Phone4178658701PhoneNum
Preparation2021-11-01PreparationDt

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 OfficerMARI KAPTAIN-DAHLENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11021 NEBRASKA STAddressLine1Txt
CitySIOUX CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51105ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$34,821,220GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SLANDCHC.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO BE A PATIENT-CENTERED MEDICAL HOME WHICH IMPROVES THE PHYSICAL, DENTAL, AND BEHAVIORAL HEALTH OF THE SIOUXLAND COMMUNITY WHILE ELIMINATING ACCESS BARRIERS.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee375TotalEmployeeCnt
Total Volunteers16TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$6,344,635PYContributionsGrantsAmt
CY Contributions Grants$6,713,145CYContributionsGrantsAmt
PY Program Service Revenue$27,273,306PYProgramServiceRevenueAmt
CY Program Service Revenue$27,843,411CYProgramServiceRevenueAmt
PY Investment Income$345,132PYInvestmentIncomeAmt
CY Investment Income$132,061CYInvestmentIncomeAmt
PY Other Revenue$42,134PYOtherRevenueAmt
CY Other Revenue$128,706CYOtherRevenueAmt
PY Total Revenue$34,005,207PYTotalRevenueAmt
CY Total Revenue$34,817,323CYTotalRevenueAmt
PY Grants And Similar Paid$305,048PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$329,226CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$20,304,865PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$22,359,280CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$11,110,570PYOtherExpensesAmt
CY Other Expenses$10,945,934CYOtherExpensesAmt
PY Total Expenses$31,720,483PYTotalExpensesAmt
CY Total Expenses$33,634,440CYTotalExpensesAmt
PY Revenues Less Expenses$2,284,724PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,182,883CYRevenuesLessExpensesAmt
Total Assets BOY$33,318,179TotalAssetsBOYAmt
Total Assets EOY$36,532,590TotalAssetsEOYAmt
Total Liabilities BOY$6,692,171TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,692,195TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$26,626,008NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$27,840,395NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionINSPIRING AND EMPOWERING OUR COMMUNITY THROUGH HEALTH EQUITY FOR ALL.MissionDesc
Significant New Program SrvcYes (true)SignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$19,984,780ExpenseAmt
Grant$329,226GrantAmt
Revenue$20,769,676RevenueAmt
DescPRIMARY AND SPECIALTY MEDICAL SERVICES FOR FYE 2021: SCHC PROVIDED MEDICAL, PRENATAL, AND BEHAVIORAL HEALTH SERVICES FOR 94,179 PATIENT VISITS. SERVICES WERE PROVIDED BY SEVEN PRIMARY CARE PHYSICIANS, EIGHT PHYSICIAN ASSISTANTS, AND EIGHTEEN NURSE PRACTITIONERS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,911,759ExpenseAmt
Revenue$4,064,809RevenueAmt
DescPHARMACY: THE SCHC PHARMACY IS AVAILABLE TO ALL PATIENTS RECEIVING HEALTH CARE SERVICES AT THE HEALTH CENTER. THREE PHARMACISTS ARE ON STAFF TO OFFER MEDICATION COUNSELING FOR PRESCRIPTIONS. IN ADDITION, THE HEALTH CENTER EMPLOYED ONE FULL-TIME CLINICAL PHARMACIST TO ASSIST PATIENTS WITH CHRONIC MEDICAL CONDITIONS. SCHC IS A PARTICIPANT IN THE 340B DRUG PRICING PROGRAM AND ALSO OFFERS AN INDIGENT PROGRAM TO PROVIDE PRESCRIPTION ASSISTANCE TO QUALIFYING PATIENTS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$2,895,633ExpenseAmt
Revenue$3,008,926RevenueAmt
DescDENTAL CARE FOR FYE 2021: SCHC EMPLOYED FIVE DENTISTS AND FIVE DENTAL HYGIENISTS TO PROVIDE ROUTINE DENTAL CARE AND TREATMENT TO PATIENTS AGED INFANTS TO ADULTS. EMERGENCY WALK-IN PATIENTS ARE ACCEPTED DAILY. THE DENTAL DEPARTMENT HAD 12,963 PATIENT VISITS DURING THE YEAR ENDING 1/31/21.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$26,792,172TotalProgramServiceExpensesAmt
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 AssetsfalseReportOtherAssetsInd
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 IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
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 ContriYes (true)DeductibleNonCashContriInd
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 Document74IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee375EmployeeCnt
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 Members14GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
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 OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldIAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJAN ANDERSON CFOPersonNm
Phone7122522477PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11021 NEBRASKA STREETAddressLine1Txt
CitySIOUX CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51105ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
MICHAEL PIPLANI
CMO40.00.0Yes (X)$327,188$0$21,231
DAVID FALDMO
QUALITY DIRECTOR40.00.0$292,632$0$46,576Yes (X)
GARY HATTAN
PHYSICIAN40.00.0$290,021$0$44,182Yes (X)
KRISTI WALZ
PHYSICIAN40.00.0$291,052$0$42,114Yes (X)
TYLER WENDEL
PHYSICIAN40.00.0$283,151$0$39,379Yes (X)
DYLAN GREENE
PHYSICIAN40.00.0$267,592$0$46,311Yes (X)
BRENDA HAUSMAN-MILLER
DENTAL DIRECTOR40.00.0$256,963$0$39,179Yes (X)
KELLY RYDER
PHYSICIAN40.00.0$269,495$0$14,200Yes (X)
MARI KAPTAIN-DAHLEN
CEO40.00.0Yes (X)$219,684$0$30,155
JAN ANDERSON
CFO40.00.0Yes (X)$201,865$0$33,025
ABDULLAHI URUR
MEMBER AT LARGE1.00.0$0$0$0Yes (X)
AMY SLEVIN
TREASURER1.00.0Yes (X)$0$0$0Yes (X)
ANDREA BUCKLEY
CHAIR1.00.0Yes (X)$0$0$0Yes (X)
KELLY MCCARTHY
MEMBER AT LARGE1.00.0$0$0$0Yes (X)
DAVID OLSON
MEMBER AT LARGE1.00.0$0$0$0Yes (X)
CHAD MARKHAM
MMR AT LAR END 08/20/SECRETARY1.00.0Yes (X)$0$0$0Yes (X)
DR DONA PRINCE
VICE CHAIR1.00.0Yes (X)$0$0$0Yes (X)
JAY ROSENBERG
MEMBER OF LARGE1.00.0$0$0$0Yes (X)
JENNIFER BRAVANTE-BURKHART
MEMBER AT LARGE1.00.0$0$0$0Yes (X)
TREYLA LEE
MEMBER AT LARGE1.00.0$0$0$0Yes (X)
REVATHI TRUONG
MEMBER AT LARGE1.00.0$0$0$0Yes (X)
MONA ZUFFANTE
MEMBER AT LARGE1.00.0$0$0$0Yes (X)
TIM DAUGHERTY
MEMBER AT LARGE BEG 10/201.00.0$0$0$0Yes (X)
WILLIE SUAREZ
MEMBER AT LARGE BEG 10/201.00.0$0$0$0Yes (X)
BIBI GAZNABBI-JAURON
MEMBER AT LARGE END 08/201.00.0$0$0$0Yes (X)
JENNIFER GOMEZ
SECRETARY END 08/201.00.0Yes (X)$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,699,643TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$356,352TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K41IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HR CONSTRUCTION
307 E 39TH STREETSOUTH SIOUX CITYNE68776BUILDING CONSTRUCTIO$2,704,160
SIOUXLAND OBGYN
2730 PIERCE STREET 201SIOUX CITYIA51104OBSTETRICAL SERVICES$724,374
INCONCERT CARE
500 SW 7TH ST STE 300DES MOINESIA50309SOFTWARE SUPPORT$714,024
BKD LLP
910 E ST LOUIS ST STE 200SPRINGFIELDMO65810AUDIT/TAX/CONSULTING$126,812
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Membership Dues$11,544MembershipDuesAmt
Government Grants$6,466,880GovernmentGrantsAmt
All Other Contributions$234,721AllOtherContributionsAmt
Noncash Contributions$736,184NoncashContributionsAmt
Total Contributions$6,713,145TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE624100$27,703,678$27,703,678
OTHER REVENUE624100$139,733$139,733
FieldValueIRS element (for citing)
Total Program Service Revenue$27,843,411TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$134,708TotalRevenueColumnAmt
Exclusion$134,708ExclusionAmt

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

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$1,250OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$3,897OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$2,647OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$2,647TotalRevenueColumnAmt
Exclusion-$2,647ExclusionAmt
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 Equity InvesteeDesc
Business900099BusinessCd
Total Revenue Column$128,706TotalRevenueColumnAmt
Exclusion$128,706ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$128,706OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,817,323TotalRevenueColumnAmt
Related Or Exempt Func Income$27,843,411RelatedOrExemptFuncIncomeAmt
Exclusion$260,767ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$329,226TotalAmt
Program Services$329,226ProgramServicesAmt

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$1,468,498TotalAmt
Program Services$983,769ProgramServicesAmt
Management And General$484,729ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$17,242,392TotalAmt
Program Services$14,388,887ProgramServicesAmt
Management And General$2,853,505ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$670,702TotalAmt
Program Services$572,955ProgramServicesAmt
Management And General$97,747ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,743,851TotalAmt
Program Services$1,378,645ProgramServicesAmt
Management And General$365,206ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,233,837TotalAmt
Program Services$974,639ProgramServicesAmt
Management And General$259,198ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$22,910TotalAmt
Management And General$22,910ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$125,718TotalAmt
Management And General$125,718ManagementAndGeneralAmt

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$2,538,275TotalAmt
Program Services$2,120,170ProgramServicesAmt
Management And General$418,105ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$139,942TotalAmt
Program Services$68,079ProgramServicesAmt
Management And General$71,863ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$663,339TotalAmt
Program Services$391,311ProgramServicesAmt
Management And General$272,028ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$967,559TotalAmt
Program Services$128,756ProgramServicesAmt
Management And General$838,803ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$384,516TotalAmt
Program Services$317,313ProgramServicesAmt
Management And General$67,203ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$8,809TotalAmt
Program Services$6,389ProgramServicesAmt
Management And General$2,420ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$267,168TotalAmt
Program Services$202,288ProgramServicesAmt
Management And General$64,880ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$5,067TotalAmt
Management And General$5,067ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$913,641TotalAmt
Program Services$169,032ProgramServicesAmt
Management And General$744,609ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$54,012TotalAmt
Program Services$6,057ProgramServicesAmt
Management And General$47,955ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$4,671,563$4,671,563
LICENSES, DUES, SUBSCRIPTIONS$152,760$83,093$69,667
RECRUITING & RETENTION$24,690$24,690
MISCELLANEOUS EXPENSE$5,965$5,965

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$33,634,440TotalAmt
Program Services$26,792,172ProgramServicesAmt
Management And General$6,842,268ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$178,450BOYAmt
EOY$122,183EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$17,745,753BOYAmt
EOY$17,447,329EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$542,836BOYAmt
EOY$837,127EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,476,841BOYAmt
EOY$3,517,444EOYAmt

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$191,413BOYAmt
EOY$251,860EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$265,929BOYAmt
EOY$232,931EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$22,279,583LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,698,404LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,568,126BOYAmt
EOY$13,581,179EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$168,831BOYAmt
EOY$297,537EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$180,000BOYAmt
EOY$245,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$33,318,179BOYAmt
EOY$36,532,590EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,073,457BOYAmt
EOY$2,461,856EOYAmt

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$3,655,594BOYAmt
EOY$3,260,293EOYAmt

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$0BOYAmt
EOY$2,292,430EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$963,120BOYAmt
EOY$677,616EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,692,171BOYAmt
EOY$8,692,195EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$26,404,810BOYAmt
EOY$27,660,662EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$221,198BOYAmt
EOY$179,733EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$26,626,008BOYAmt
EOY$27,840,395EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$33,318,179BOYAmt
EOY$36,532,590EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,182,883ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$31,504NetUnrlzdGainsLossesInvstAmt
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$5,776,438CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,185,636CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,384,273CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,344,635CurrentTaxYearMinus1YearAmt
Current Tax Year$6,713,145CurrentTaxYearAmt
Total$31,404,127TotalAmt

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$5,776,438CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,185,636CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,384,273CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,344,635CurrentTaxYearMinus1YearAmt
Current Tax Year$6,713,145CurrentTaxYearAmt
Total$31,404,127TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$31,404,127PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$31,233CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$103,083CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$220,216CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$353,248CurrentTaxYearMinus1YearAmt
Current Tax Year$134,708CurrentTaxYearAmt
Total$842,488TotalAmt

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$32,246,615TotalSupportAmt
Gross Receipts Rltd Activities$123,764,989GrossReceiptsRltdActivitiesAmt
Public Support CY1700.97387PublicSupportCY170Pct
Public Support PY1700.97588PublicSupportPY170Pct
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 PAID DUES OF $20,000 TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND $43,644 TO THE IOWA PRIMARY CARE ASSOCIATION. A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO 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$1,271,327OtherCostOrOtherBasisAmt
Book Value$1,271,327BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,478,454OtherCostOrOtherBasisAmt
Depreciation$5,905,171DepreciationAmt
Book Value$8,573,283BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,849,258OtherCostOrOtherBasisAmt
Depreciation$2,793,233DepreciationAmt
Book Value$2,056,025BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,680,544OtherCostOrOtherBasisAmt
Book Value$1,680,544BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,581,179TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
INTEREST RATE SWAP$391,616
EST. DUE TO THIRD PARTIES$286,000
FieldValueIRS element (for citing)
Total Liability$677,616TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$34,895,989TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$31,504NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$3,050DonatedServicesAndUseFcltsAmt
Other Revenue$213,456OtherRevenueAmt
Revenue Not Reported$248,010RevenueNotReportedAmt
Revenue Subtotal$34,647,979RevenueSubtotalAmt
Other Revenues Not Included$169,344OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$169,344RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$34,817,323TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$33,640,137TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$3,050DonatedServicesUseFcltsAmt
Other Expenses Included$2,647OtherExpensesIncludedAmt
Expenses Not Reported$5,697ExpensesNotReportedAmt
Expenses Subtotal$33,634,440ExpensesSubtotalAmt
Total Expenses Per Form990$33,634,440TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 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 2DAMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ 213,456 NET ASSETS RELEASED FROM RESTRICTION
SCHEDULE D, PART XI, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 171,991 TEMPORARILY RESTRICTED CONTRIBUTIONS (2,647) LOSS ON DISPOSAL OF ASSET ------------- $ 169,344
SCHEDULE D, PART XII, LINE 2DAMOUNTS INCLUDED ON FORM 990, PART VII, LINE 2D, BUT NOT ON LINE 1: $ 2,647 LOSS ON ASSET DISPOSAL

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (4 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
RENTAL ASSISTANCE PROGRAM49$197,620
CO-PAY ASSISTANCE PROGRAM85$73,570
FOOD ASSISTANCE PROGRAM117$28,000
UTILITIES ASSISTANCE PROGRAM48$30,036

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationMONITORING OF GRANT FUNDS: PATIENTS WITHIN THE HIV PROGRAM MAY QUALIFY FOR THE FOLLOWING PROGRAMS: RENTAL ASSISTANCE, MEDICAL/DENTAL CO-PAY ASSISTANCE, FOOD ASSISTANCE, AND UTILITIES ASSISTANCE. INDIVIDUALS MUST DEMONSTRATE A NEED FOR FINANCIAL ASSISTANCE AND THEY MUST FOLLOW-UP REGULARLY WITH THE STAFF AT THE CLINIC.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
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 (10 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
MICHAEL PIPLANI
CMO$319,945$0$1,250$0$5,993$0$14,250$0$6,981$0$348,419$0$0$0
MARI KAPTAIN-DAHLEN
CEO$217,348$0$1,250$0$1,086$0$10,887$0$19,268$0$249,839$0$0$0
JAN ANDERSON
CFO$192,077$0$1,250$0$8,538$0$10,482$0$22,543$0$234,890$0$0$0
KRISTI WALZ
PHYSICIAN$285,994$0$4,800$0$258$0$13,875$0$28,239$0$333,166$0$0$0
GARY HATTAN
PHYSICIAN$287,535$0$1,400$0$1,086$0$14,250$0$29,932$0$334,203$0$0$0
TYLER WENDEL
PHYSICIAN$271,295$0$2,880$0$8,976$0$14,250$0$25,129$0$322,530$0$0$0
DYLAN GREENE
PHYSICIAN$257,707$0$5,600$0$4,285$0$13,178$0$33,133$0$313,903$0$0$0
KELLY RYDER
PHYSICIAN$257,264$0$3,620$0$8,611$0$12,991$0$1,209$0$283,695$0$0$0
DAVID FALDMO
QUALITY DIRECTOR$245,412$0$26,750$0$20,470$0$14,250$0$32,326$0$339,208$0$0$0
BRENDA HAUSMAN-MILLER
DENTAL DIRECTOR$245,795$0$5,300$0$5,868$0$9,204$0$29,975$0$296,142$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 7FormAndLineReferenceDesc
ExplanationNONFIXED PAYMENTS: MONTHLY INCENTIVE PAYMENTS BASED ON PRODUCTION ARE PAID TO EMPLOYEES SUBJECT TO THE DISCRETION OF THE BOARD OF DIRECTORS.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WOODBURY COUNTY IOWABusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN426005221BondIssuerEIN
Bond Issued2007-09-25BondIssuedDt
Issue Price$7,000,000IssuePriceAmt
PurposeCONSTRUCTION OF NEW FACILITYPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$3,705,852RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$7,000,000TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$100,000IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$6,900,000WorkingCapitalExpendituresAmt
Capital Expenditures$0CapitalExpendituresAmt
Other Spent Proceeds$0OtherSpentProceedsAmt
Unspent$0UnspentAmt
Substantial Completion2009SubstantialCompletionYr
Refunding Tax Exempt BondsfalseRefundingTaxExemptBondsInd
Refunding Taxable BondsfalseRefundingTaxableBondsInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Bond Iss Meet Prvt Sec Pymt TestYes (true)BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DueYes (true)NoRebateDueInd
Variable Rate IssueYes (true)VariableRateIssueInd
Hedge Identified In Bks And RecYes (true)HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line1WELLS FARGOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Term Of Hedge20.TermOfHedgePct
Superintegrated HedgefalseSuperintegratedHedgeInd
Hedge TerminatedfalseHedgeTerminatedInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE K, PART IV, LINE 2CFormAndLineReferenceDesc
ExplanationNO REBATE DUE: THE COMPUTATION WAS PERFORMED AS OF 11/02/2017.ExplanationTxt

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp
Clothing And Household GoodsClothingAndHouseholdGoodsGrp
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp
Securities Publicly TradedSecuritiesPubliclyTradedGrp
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp
CollectiblesCollectiblesGrp
Food InventoryFoodInventoryGrp

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution2ContributionCnt
Noncash Contributions Rpt F990$697,827NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescPPEDesc
Contribution3ContributionCnt
Noncash Contributions Rpt F990$38,357NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE M, PART I, LINE 20, COLUMN (B)FormAndLineReferenceDesc
ExplanationNUMBER OF CONTRIBUTIONS: THE NUMBERS ENTERED IN COLUMN B REPRESENT THE NUMBER OF DONORS WHO CONTRIBUTED THESE ITEMS DURING THE YEAR.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2SIGNIFICANT PROGRAM SERVICES: DUE TO THE COVID-19 PANDEMIC, THE HEALTH CENTER BEGAN OFFERING TELEHEALTH SERVICES AND MOBILE HEALTH SERVICES.
FORM 990, PART III, LINE 4PROGRAM SERVICES: SIOUXLAND COMMUNITY HEALTH CENTER (SCHC) IS DEDICATED TO MEETING THE HEALTHCARE NEEDS OF THE SIOUXLAND AREA AND IS A LEVEL THREE PATIENT CENTERED MEDICAL HOME. SCHC OFFERS THE FOLLOWING SERVICES: PRIMARY AND SPECIALTY MEDICAL SERVICES, FAMILY PLANNING SERVICES PRENATAL SERVICES, LABORATORY, RADIOLOGY, HIV/AIDS AND HEPATITIS CARE, BEHAVIORAL HEALTH, PHARMACY, AND DENTAL SERVICES. SCHC PROVIDES FINANCIAL ASSISTANCE TO THE UNINSURED AND UNDERINSURED TO ELIMINATE ACCESS BARRIERS.
FORM 990, PART III, LINE 4APROGRAM SERVICE ACTIVITY #1: LABORATORY SIOUXLAND COMMUNITY HEALTH CENTER CURRENTLY CONDUCTS APPROXIMATELY 96% OF ITS LABORATORY TESTS ONSITE AND IS A MODERATE COMPLEX LABORATORY. FOR THOSE TESTS NOT PERFORMED ONSITE, THEY ARE SENT TO A REFERENCE LABORATORY WHERE THE MAJORITY OF TEST RESULTS ARE RETURNED WITHIN 24-72 HOURS. CONDUCTING THE MAJORITY OF TESTS ONSITE ENSURES RAPID TURNAROUND FOR DIAGNOSIS AND MONITORING OF CHRONIC MEDICAL CONDITIONS. THE LABORATORY WAS ACCREDITED BY CLIA FOR THE YEAR ENDING 1/31/21, THE LABORATORY PERFORMED 610,112 TESTS. RADIOLOGY SCHC ALSO CONDUCTS RADIOLOGY SERVICES. IT PERFORMED 4,590 EXAMS FOR THE YEAR ENDING 1/31/21. SCHC ALSO STARTED PROVIDING ULTRASOUND SERVICES ON 3/1/20 AND PERFORMED 1,642 EXAMS FOR THE YEAR ENDING 1/31/21. HIV/AIDS AND HEPATITIS THE HIV TEAM SERVES THE TRI-STATE SIOUXLAND AREA, AS WELL AS 20 NORTHWEST IOWA COUNTIES, 6 COUNTIES IN NEBRASKA, AND 3 COUNTIES IN SOUTH DAKOTA. APPROXIMATELY 48% OF PATIENTS RECEIVING HIV/AIDS CARE LIVE IN RURAL AREAS. IN ADDITION TO MEDICAL CARE, THE HIV TEAM COORDINATES DENTAL CARE, CASE MANAGEMENT, TRANSPORTATION, AND HOUSING ASSISTANCE. FOR THE FISCAL YEAR ENDING 1/31/21, THE HIV TEAM SERVED 214 PATIENTS. FINANCIAL SERVICES TO ENSURE PATIENTS HAVE ACCESS TO CARE AT AN AFFORDABLE RATE, SCHC OFFERS A SLIDING FEE DISCOUNT TO PATIENTS BASED ON INCOME ELIGIBILITY AND ACCEPTS MEDICAID (TITLE 19), MEDICARE (TITLE 18), HAWK-I (STATE CHIP) AND MOST PRIVATE INSURANCES. FOR FISCAL YEAR ENDING 1/31/21, 15% OF PATIENTS RECEIVING CARE WERE UNINSURED, 43% HAD COVERAGE BY MEDICAID/HAWK-I, 9% HAD MEDICARE COVERAGE, AND 33% HAD COVERAGE BY OTHER SOURCES. SCHC EMPLOYED SIX CERTIFIED APPLICATION COUNSELORS TO ASSIST INDIVIDUALS WITH ENROLLMENT IN THE HEALTH INSURANCE EXCHANGE.
FORM 990, PART III, LINE 4BPROGRAM SERVICE ACTIVITY #2: THE SCHC PHARMACY ALSO PARTICIPATES IN OTHER PHARMACEUTICAL ASSISTANCE PROGRAMS TO ENSURE PATIENTS HAVE ACCESS TO NEEDED PRESCRIPTION DRUGS.
FORM 990, PART VI, SECTION B, LINE 11BREVIEW OF THE FORM 990: 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. THE CEO AND CFO REVIEW THE RETURN BEFORE IT IS PRESENTED TO THE FINANCE COMMITTEE. THE FINANCE COMMITTEE APPROVES THE RETURN, AND THE FINANCE COMMITTEE CHAIR MAKES A RECOMMENDATION TO THE BOARD FOR APPROVAL OF THE FORM 990 FOR FILING WITH THE IRS. BOARD MEMBERS RECEIVE THE FORM 990 AS HARD COPIES (MAILED OR HAND-DELIVERED) OR ELECTRONIC FILES (SENT VIA E-MAIL).
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST POLICY: A CONFLICT OF INTEREST POLICY IS STATED IN THE EMPLOYEE HANDBOOK. PER THE BYLAWS, IF A QUESTION CONCERNING A CONFLICT OF INTEREST FOR ANY DIRECTOR IS RAISED, A WRITTEN SECRET BALLOT MAY BE USED BY THE REMAINING DIRECTORS TO DETERMINE IF SUCH CONFLICT OF INTEREST EXISTS. SHOULD A CONFLICT OF INTEREST, PECUNIARY OR OTHERWISE, BE DETERMINED FOR ANY DIRECTOR, SUCH DIRECTOR SHALL BE EXCLUDED FROM VOTING ON THAT SUBJECT MATTER. A SIMPLE, AFFIRMATIVE MAJORITY OF THOSE PRESENT SHALL RULE. IN ALL EVENTS, A DIRECTOR SHALL DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15ACEO COMPENSATION REVIEW: THE CEO'S COMPENSATION WAS EVALUATED IN 2020 BY THE EXECUTIVE BOARD OF DIRECTORS USING A COMPREHENSIVE CEO PERFORMANCE EVALUATION TOOL. THE EXECUTIVE BOARD ASSESSED THE CEO'S INDIVIDUAL PERFORMANCE, THE ORGANIZATION'S PERFORMANCE, AND WHETHER THE CEO ACCOMPLISHED THE MUTUALLY-AGREED UPON OBJECTIVES FOR THE FISCAL YEAR BEING REVIEWED. THE HR DIRECTOR CONDUCTS AN IN-DEPTH SALARY ANALYSIS ON A BI-ANNUAL BASIS WITH A CURSORY ANALYSIS DURING THE ALTERNATE YEARS. THE DATA USED IS OBTAINED LOCALLY, REGIONALLY, AND NATIONALLY. THIS ANALYSIS IS COMPILED AND A RECOMMENDATION IS TAKEN TO THE EXECUTIVE BOARD. THE CEO'S ANNUAL PERFORMANCE EVALUATION IS CALCULATED BY THE EXECUTIVE BOARD TO DETERMINE THE CURRENT YEAR SALARY, AND THE SALARY ANALYSIS IS COMPARED TO ENSURE THAT THE SALARY IS APPROPRIATE FOR THE POSITION AND PERFORMANCE.
FORM 990, PART VI, SECTION B, LINE 15BOTHER OFFICER COMPENSATION REVIEW: THE CFO'S AND THE CMO'S COMPENSATION WAS EVALUATED IN 2019 BY THE CEO USING A COMPREHENSIVE PERFORMANCE EVALUATION TOOL. THE CEO ASSESSED THE CFO'S AND THE CMO'S INDIVIDUAL PERFORMANCE, THE ORGANIZATION'S PERFORMANCE, AND WHETHER THE CFO AND THE CMO ACCOMPLISHED THE MUTUALLY AGREED UPON OBJECTIVES FOR THE FISCAL YEAR BEING REVIEWED.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS WILL BE PROVIDED TO INQUIRING PARTIES UPON REQUEST.