SOUTHSIDE COMMUNITY HEALTH SERVICES INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
SOUTHSIDE COMMUNITY HEALTH SERVICES INC (EIN 23-7113799)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-02
IRS object ID
202123069349301107
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)
Return2021-11-02T08:39:05-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN411534805PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CARPENTER EVERT & ASSOCIATES LTDBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line17760 FRANCE AVE S SUITE 940AddressLine1Txt
CityBLOOMINGTONCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55435ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN237113799EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SOUTHSIDE COMMUNITY HEALTH SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSOUTBusinessNameControlTxt
Phone6128223282PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14243 FOURTH AVENUE SOUTHAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55409ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANN CAZABANPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone6128223282PhoneNum
Signature2021-11-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstANNPersonFirstNm
Person LastCAZABANPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNEAL EVERTPreparerPersonNm
PTINP00046853PTIN
Phone9528310085PhoneNum
Preparation2021-11-01PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerANN CAZABANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14243 FOURTH AVENUE SOUTHAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55409ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$9,610,035GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SOUTHSIDECHS.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1971FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO PROVIDE HIGH QUALITY HEALTH CARE IN THE COMMUNITIES SERVED.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee119TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,327,833PYContributionsGrantsAmt
CY Contributions Grants$5,625,759CYContributionsGrantsAmt
PY Program Service Revenue$5,096,391PYProgramServiceRevenueAmt
CY Program Service Revenue$3,965,507CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$47,489PYOtherRevenueAmt
CY Other Revenue$18,769CYOtherRevenueAmt
PY Total Revenue$9,471,713PYTotalRevenueAmt
CY Total Revenue$9,610,035CYTotalRevenueAmt
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$5,606,804PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,545,410CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,468,820PYOtherExpensesAmt
CY Other Expenses$3,130,589CYOtherExpensesAmt
PY Total Expenses$8,075,624PYTotalExpensesAmt
CY Total Expenses$8,675,999CYTotalExpensesAmt
PY Revenues Less Expenses$1,396,089PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$934,036CYRevenuesLessExpensesAmt
Total Assets BOY$2,181,177TotalAssetsBOYAmt
Total Assets EOY$2,905,207TotalAssetsEOYAmt
Total Liabilities BOY$1,180,746TotalLiabilitiesBOYAmt
Total Liabilities EOY$970,740TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,000,431NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,934,467NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSOUTHSIDE COMMUNITY HEALTH SERVICES EXISTS TO SERVE THE COMMUNITY BY OFFERING FRIENDLY, SUPERIOR, QUALITY AND FISCALLY RESPONSIBLE HEALTH SERVICES IN AN ENVIRONMENT THAT FOSTERS LEARNING AND RESPECT. IT DOES THIS THROUGH COLLABORATION AND COMMUNICATION WHICH PATIENTS ACCEPT AS AN OPPORTUNITY TO IMPROVE THEIR HEALTH.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,447,998ExpenseAmt
DescMEDICAL: SOUTHSIDE MEDICAL CURRENTLY PROVIDES FAMILY PRACTICE MEDICINE INCLUDING SPECIAL PROGRAMS FOR AT RISK POPULATIONS, FAMILY PLANNING, PRENATAL AND PEDIATRICS. SOUTHSIDE COMMUNITY HEALTH SERVICES, INC. (SCHS) IS A 501(C)3 NONPROFIT ORGANIZATION AND IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) LOCATED IN SOUTH MINNEAPOLIS. SCHS HAS ONE MEDICAL CLINIC LOCATED IN MINNEAPOLIS AND A DENTAL AND VISION CLINIC LOCATED IN MINNEAPOLIS. WHILE THE MAJORITY OF PATIENTS COME FROM THE SOUTHSIDE OF MINNEAPOLIS, SCHS DRAWS PATIENTS FROM ACROSS THE TWIN CITIES METROPOLITAN AREA. SCHS CONTINUES TO HAVE AN "ESSENTIAL COMMUNITY SAFETY NET PROVIDER" DESIGNATION FROM THE STATE OF MINNESOTA.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,017,733ExpenseAmt
DescDENTAL: SOUTHSIDE DENTAL CLINIC CURRENTLY PROVIDES GENERAL DENTAL SERVICES FOR PEOPLE OF ALL AGES. SOUTHSIDE CURRENTLY OPERATES TWELVE DENTAL OPERATORIES AND CONTINUES TO OPERATE A MOBILE DENTAL UNIT EQUIPPED WITH TWO DENTAL OPERATORIES.IN 2020, SOUTHSIDE PROVIDED 25,112 VISITS BETWEEN MEDICAL, BEHAVIORAL HEALTH, DENTAL, AND VISION.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$170,605ExpenseAmt
DescOUTREACH: SOUTHSIDE'S OUTREACH PROGRAM PROVIDES THE COMMUNITY WITH INNOVATIVE PROGRAMS, ACTIVITIES AND EDUCATIONAL OPPORTUNITIES DESIGNED TO IMPROVE HEALTH LITERACY AND ASSIST PEOPLE IN GETTING INVOLVED IN THEIR PERSONAL HEALTH CARE. IT HAS BEEN PROVEN THAT THE EARLIER HEALTHY PRACTICES ARE ESTABLISHED, THE BETTER THE QUALITY OF LIFE FOR THE INDIVIDUAL. THESE PRACTICES CAN INCLUDE HEALTHY DIET, CONSISTENT EXERCISE AND MONITORING LIFESTYLE CHOICES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$7,636,336TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee119EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6128229030PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14243 FOURTH AVENUE SOUTHAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55409ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
KALEECA BIBLE
DIRECTOR1.00Yes (X)$0$0$0
BRIAN OSBERG
CHAIR1.00Yes (X)$0$0$0Yes (X)
JIM GALLAGHER
SECRETARY1.00Yes (X)$0$0$0Yes (X)
KRISTY GRAUME
DIRECTOR1.00Yes (X)$0$0$0
MICHELLE EVANS
DIRECTOR1.00Yes (X)$0$0$0
PATRICK LYTLE
VICE CHAIR1.00Yes (X)$0$0$0Yes (X)
SHAUN ZEIG
TREASURER1.00Yes (X)$0$0$0Yes (X)
ANGEL EVEN
DIRECTOR1.00Yes (X)$0$0$0
EMILY ANDERSON
DIRECTOR1.00Yes (X)$0$0$0
D'WAYNE MORRIS
DIRECTOR1.00Yes (X)$0$0$0
ANN CAZABAN
EXECUTIVE DIRECTOR40.00$160,000$0$5,482Yes (X)
MARK BUECHELE
FINANCE DIRECTOR11.00$54,730$0$0Yes (X)
BRIAN QUINLAN
DENTAL DIRECTOR40.00$175,055$0$5,210Yes (X)
JAYME NOESKE
DENTIST40.00$149,350$0$3,269Yes (X)
DANIEL PIERRE GINGERICH-BOBERG
PHYSICIAN40.00$145,000$0$0Yes (X)
RACHEL CARPINO
DENTIST40.00$149,350$0$4,033Yes (X)
MEREDITH WALBURG
OPTOMETRIST40.00$139,256$0$5Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$972,741TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$17,999TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonGLORIMAR RIVERAPersonNm

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line14243 FOURTH AVENUE SOUTHAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55409ZIPCd
FieldValueIRS element (for citing)
ServicesBILLINGServicesDesc
Compensation$187,133CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$5,319,638GovernmentGrantsAmt
All Other Contributions$306,121AllOtherContributionsAmt
Total Contributions$5,625,759TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT FEESDesc
Business621400BusinessCd
Total Revenue Column$3,965,507TotalRevenueColumnAmt
Related Or Exempt Func Income$3,965,507RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$3,965,507TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS REVENUEDesc
Business621400BusinessCd
Total Revenue Column$18,769TotalRevenueColumnAmt
Related Or Exempt Func Income$18,769RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$18,769OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,610,035TotalRevenueColumnAmt
Related Or Exempt Func Income$3,984,276RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$400,477TotalAmt
Program Services$358,515ProgramServicesAmt
Management And General$41,962ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,309,681TotalAmt
Program Services$3,858,118ProgramServicesAmt
Management And General$451,563ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$429,959TotalAmt
Program Services$384,908ProgramServicesAmt
Management And General$45,051ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$405,293TotalAmt
Program Services$362,827ProgramServicesAmt
Management And General$42,466ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$614,323TotalAmt
Program Services$426,275ProgramServicesAmt
Management And General$188,048ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$484,107TotalAmt
Program Services$412,765ProgramServicesAmt
Management And General$71,342ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$459,976TotalAmt
Program Services$411,668ProgramServicesAmt
Management And General$48,308ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$234,034TotalAmt
Program Services$188,840ProgramServicesAmt
Management And General$45,194ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$39,375TotalAmt
Program Services$12,022ProgramServicesAmt
Management And General$27,353ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$26,876TotalAmt
Management And General$26,876ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$305,649TotalAmt
Program Services$273,623ProgramServicesAmt
Management And General$32,026ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$19,289TotalAmt
Program Services$17,268ProgramServicesAmt
Management And General$2,021ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBTS$711,693$711,693
SUPPLIES$131,000$131,000
MINNESOTA PROVIDERS TAX$63,972$63,972
OTHER EXPENSE$21,571$17,348$4,223

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$18,724TotalAmt
Program Services$5,494ProgramServicesAmt
Management And General$13,230ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,675,999TotalAmt
Program Services$7,636,336ProgramServicesAmt
Management And General$1,039,663ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$309,610BOYAmt
EOY$1,222,871EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$106,578BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$709,634BOYAmt
EOY$227,338EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$7,288BOYAmt
EOY$11,267EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$4,180,250LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,736,519LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,048,067BOYAmt
EOY$1,443,731EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,181,177BOYAmt
EOY$2,905,207EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$630,902BOYAmt
EOY$470,473EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$547,240BOYAmt
EOY$500,267EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,604BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,180,746BOYAmt
EOY$970,740EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,000,431BOYAmt
EOY$1,934,467EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,000,431BOYAmt
EOY$1,934,467EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,181,177BOYAmt
EOY$2,905,207EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$934,036ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,692,316CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,012,303CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,226,004CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,327,833CurrentTaxYearMinus1YearAmt
Current Tax Year$5,625,759CurrentTaxYearAmt
Total$18,884,215TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,682,713CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,941,378CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,981,110CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,096,391CurrentTaxYearMinus1YearAmt
Current Tax Year$3,965,507CurrentTaxYearAmt
Total$21,667,099TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,375,029CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,953,681CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,207,114CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,424,224CurrentTaxYearMinus1YearAmt
Current Tax Year$9,591,266CurrentTaxYearAmt
Total$40,551,314TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$40,551,314PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$37CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$433CurrentTaxYearMinus3YearsAmt
Total$470TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$37CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$433CurrentTaxYearMinus3YearsAmt
Total$470TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$88,492CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$88,365CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$48,611CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$47,489CurrentTaxYearMinus1YearAmt
Current Tax Year$18,769CurrentTaxYearAmt
Total$291,726TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,463,558CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,042,479CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,255,725CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,471,713CurrentTaxYearMinus1YearAmt
Current Tax Year$9,610,035CurrentTaxYearAmt
Total$40,843,510TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99280PublicSupportCY509Pct
Public Support PY5090.99250PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER INCOME - 2016 AMOUNT: $ 88,492. 2017 AMOUNT: $ 88,365. 2018 AMOUNT: $ 48,611. 2019 AMOUNT: $ 47,489. 2020 AMOUNT: $ 18,769.ExplanationTxt

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 D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$130,543OtherCostOrOtherBasisAmt
Book Value$130,543BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,289,188OtherCostOrOtherBasisAmt
Depreciation$880,075DepreciationAmt
Book Value$409,113BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$315,603OtherCostOrOtherBasisAmt
Depreciation$315,603DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,444,916OtherCostOrOtherBasisAmt
Depreciation$1,540,841DepreciationAmt
Book Value$904,075BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,443,731TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$9,610,035TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$9,610,035RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$9,610,035TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$8,675,999TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$8,675,999ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$8,675,999TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION HAS A TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAS ADOPTED ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, ASC 740-10. THE ORGANIZATIONS POLICY IS TO EVALUATE UNCERTAIN TAX POSITIONS, AT LEAST ANNUALLY, FOR THE POTENTIAL FOR INCOME TAX EXPOSURE FROM UNRELATED BUSINESS INCOME OR FROM LOSS OF NONPROFIT STATUS. THE ORGANIZATION CONTINUES TO OPERATE CONSISTENT WITH ITS ORIGINAL EXEMPTION APPLICATION AND EACH YEAR TAKES THE NECESSARY ACTIONS TO MAINTAIN ITS EXEMPT STATUS. IT HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER THE INTERNAL REVENUE CODE AND CHARITABLE CONTRIBUTIONS BY DONORS ARE TAX DEDUCTIBLE. IN COMPLIANCE WITH ITS EXEMPT STATUS, THE ORGANIZATION ANNUALLY FILES A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990). THE RETURNS FOR THE YEARS ENDING DECEMBER 31, 2013 AND LATER REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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
BRIAN QUINLAN
DENTAL DIRECTOR$175,055$0$0$0$0$0$0$0$5,210$0$180,265$0$0$0
ANN CAZABAN
EXECUTIVE DIRECTOR$160,000$0$0$0$0$0$0$0$5,482$0$165,482$0$0$0
RACHEL CARPINO
DENTIST$149,350$0$0$0$0$0$0$0$4,033$0$153,383$0$0$0
JAYME NOESKE
DENTIST$149,350$0$0$0$0$0$0$0$3,269$0$152,619$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BLINE 11B EXPLANATION - A DRAFT OF THE 990 IS PRESENTED TO THE EXECUTIVE COMMITTEE FOR REVIEW AND QUESTIONS. ONCE APPROVED BY THE COMMITTEE, THE 990 WILL BE FILED.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE UPDATED ANNUALLY FOR ALL BOARD MEMBERS AND EMPLOYEES. ANY CONFLICT OF INTEREST MUST BE IMMEDIATELY DISCLOSED TO THE EXECUTIVE DIRECTOR IN WRITING. NO MEMBER OF THE BOARD MAY VOTE ON MATTERS ON ANY AREA WHERE THEY MAY RECEIVE FINANCIAL GAIN OR WHICH MAY CONFLICT WITH MEMBER OBLIGATIONS.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE DIRECTOR REVIEWS AND APRROVES THE COMPENSATION OF THE OTHER OFFICERS USING A MARKET SURVEY CONDUCTED BY AN OUTSIDE HR CONSULTANT. THE EXECUTIVE COMMITTEE USED EXECUTIVE SALARY SURVEYS FOR COMPARABILITY PURPOSES TO UPDATE THE EXECUTIVE DIRECTOR'S COMPENSATION. THE DECISION OF THE EXECUTIVE COMMITTEE WAS ALSO REVEIWED AND APPROVED BY THE FULL BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19NO OTHER DOCUMENTS AVAILABLE TO THE PUBLIC.

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