2021-11-11T11:29:33-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2020-01-01 043634356 BOUNDARY REGIONAL HEALTH CENTER INC BOUN 2082678422 301 CEDAR STREET NO 206 SANDPOINT ID 83864 KEVIN KNEPPER CEO/CFO 2082678422 2021-11-09 1 KEVIN KNEPPER 999009999 KURT BENNION CPA P01469618 4252506100 2021-11-09 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z KANIKSU HEALTH SERVICE KEVIN KNEPPER 301 CEDAR STREET NO 206 SANDPOINT ID 83864 18417879 0 X WWW.KANIKSUHEALTHSERVICES.ORG X 2002 ID TO PROVIDE HIGH QUALITY, COST EFFECTIVE, CULTURALLY SENSITIVE HEALTH CARE SERVICES. 12 12 190 12 0 0 3969709 7476731 10034534 10588509 0 0 297098 352639 14301341 18417879 9186 6278 0 0 10064460 11052996 0 0 0 4079212 4492579 14152858 15551853 148483 2866026 2976861 8080007 2155560 4392680 821301 3687327 X THE MISSION OF KANIKSU HEALTH SERVICES IS TO PROVIDE HIGH QUALITY, COST EFFECTIVE, CULTURALLY SENSITIVE HEALTH CARE SERVICES. 0 0 6350913 6278 5738971 KANIKSU HEALTH SERVICES (CENTER) PROVIDED MEDICAL VISITS TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED MEDICAL ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 2343511 0 2117702 KANIKSU HEALTH SERVICES (CENTER) PROVIDED PEDIATRIC MEDICAL VISITS TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED PEDIATRIC CARE REGARDLESS OF A PERSON'S ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 2038854 0 1842401 KANIKSU HEALTH SERVICES (CENTER) PROVIDED DENTAL VISITS TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED DENTAL ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 984275 0 889435 KANIKSU HEALTH SERVICES (CENTER) PROVIDED BEHAVIORAL HEALTH SERVICES TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED BEHAVIORAL HEALTH ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 0 0 0 KANIKSU HEALTH SERVICES WAS A KEY PLAYER IN THE FIGHT AGAINST THE CORONAVIRUS PANDEMIC IN 2020. WE WORKED WITH LOCAL GOVERNEMENTS AND THE COMMUNITY TO PLAN AND IMPLEMENT COMMUNITY WIDE PREVENTION STRATEGIES AND TACTICS. WE WERE ONE OF THE FIRST ORGAINZATIONS IN OUR COMMUNITY TO IMPLEMENT EMERGENCY OPERATING CLINICAL PROTOCOLS WITH A FOCUS ON PATIENT AND STAFF SAFETY. ALTHOUGH THERE WERE LIMITATIONS THROUGHOUT THE YEAR, WE WERE ABLE TO CONTINUE TO PROVIDE QUALITY CARE TO OUR PATIENTS, IMPLEMENT SAFE COVID TESTING PROCEDURES AND IN QUARTER FOUR, BEGAN PLANNING FOR THE RELEASE OF VACCINES WITHIN OUR COMMUNITY. 984275 0 889435 11717553 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 18 0 190 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X EMMA KEVERKAMP 2082637101 301 CEDAR STREET NO 206 SANDPOINT ID 83864 STEPHEN CHRISTIENSEN FAMILY PRACTICE CHIEF 36.00 X 220093 0 25000 PETER KELTERBORN INTERNAL MEDICINE PHYSICIAN 40.00 X 216161 0 21410 ADAM WEAVER DENTAL CHIEF 40.00 X 191780 0 19500 GEORGE DELAND PEDIATRICIAN 36.00 X 198701 0 12525 BEN STOCKTON FAMILY PRACTICE PHYSICIAN 40.00 X 186694 0 20659 KEVIN KNEPPER CEO/CFO 40.00 X 169998 0 25000 NICK MILLER DENTIST 40.00 X 181845 0 7274 HAILEY ROSE PEDIATRICS CHIEF 40.00 X 170547 0 13164 TERESA KUHTA PEDIATRICIAN 36.00 X 152649 0 21410 AMBER VILLELLI COO 40.00 X 112665 0 8156 SHEILA FARMIN-AUMICK CHAIR 2.00 X X 0 0 0 JOY JANSEN PHD VICE CHAIR 2.00 X X 0 0 0 MARY READER SECRETARY & DIRECTOR (THROUGH MAY 2020) 2.00 X X 0 0 0 ASHLEY WENDLAND DIRECTOR & SECRETARY 2.00 X X 0 0 0 MATTHEW WILLIAMS TREASURER 2.00 X X 0 0 0 JOE ENGLISH DIRECTOR 2.00 X 0 0 0 PEGGY FRYE DIRECTOR 2.00 X 0 0 0 DEBORAH KERR DIRECTOR 2.00 X 0 0 0 JOSH LEONARD DIRECTOR 2.00 X 0 0 0 KATE MCALLISTER DIRECTOR 2.00 X 0 0 0 KARI SNYDER DIRECTOR 2.00 X 0 0 0 RON STULTZ DIRECTOR 2.00 X 0 0 0 1801133 0 174098 19 0 1 0 N IDAHO FAMILY PHYSICIANS 8836 N HESS STREET SUITE B HAYDEN ID 83835 BILLING SERVICES 577240 D'ZIGN 21 COMMERCE DRIVE SUITE A HAYDEN ID 83835 ARCHITECTURAL SERVICES 530025 KOOTENAI HEALTH 2003 KOOTENAI HEALTH WAY COEUR DALENE ID 83814 SOFTWARE SUPPORT 163241 JOHN SEAMAN 887 TREETOP BLUFF LANE BONNERS FERRY ID 83805 MEDICAL SERVICES 128948 4 7345102 131629 741411 7476731 PATIENT REVENUE, NET 621110 8609392 8609392 340B PHARMACY REVENUE 621110 1979117 1979117 10588509 MISCELLANEOUS REVENUE 561499 352639 352639 352639 18417879 10588509 0 352639 6278 6278 955903 576076 379827 7394446 5701180 1693266 160553 138439 22114 1873018 1410857 462161 669076 504295 164781 229073 162549 66524 5581 5581 989212 384832 604380 64268 30510 33758 64675 6650 58025 131177 93082 38095 705719 489524 216195 20710 13343 7367 7922 5104 2818 45857 45025 832 176830 176830 42099 19249 22850 MEDICAL SUPPLIES 1679785 1679785 BAD DEBT 136733 136733 EQUIP. MAINT. & REPAIRS 79906 75536 4370 TRAINING 54343 35013 19330 58689 26663 32026 15551853 11717553 3834300 0 167018 3394560 1084110 809988 69568 46425 5296073 1467039 1656165 3829034 2976861 8080007 1010270 1617140 338146 1145290 2437394 2155560 4392680 X 821301 3687327 821301 3687327 2976861 8080007 2866026 0 X 0 1 X 1 1 1 X 3103320 3049220 3602844 3969709 7476731 21201824 3103320 3049220 3602844 3969709 7476731 21201824 21201824 18 1 19 201075 392304 353766 297098 352639 1596882 22798725 47669751 0.93000 0.92430 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1027334 1027334 1864929 413347 1451582 95063 95063 1063438 1053692 9746 1245309 1245309 3829034 X 18281146 0 18281146 136733 136733 18417879 15415120 0 15415120 136733 136733 15551853 PART X, LINE 2: THE CENTER HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE CENTER'S TAX POSITIONS AND CONCLUDED THAT THE CENTER HAD TAKEN NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 136,733. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 136,733. 1 PART I, LINE 2: CONTRIBUTIONS ARE MADE TO LOCAL CHARITIES AND GOVERNMENT AGENCIES. CONTRIBUTIONS ARE MADE TO OTHER ORGANIZATIONS WHOSE MISSION AND ACTIVITIES ARE CONSISTENT WITH OUR MISSION. ASIDE FROM CONFIRMING CHARITABLE OR GOVERNMENTAL STATUS OF THE RECIPIENT, WE DO NOT MONITOR HOW THE FUNDS ARE USED. PART II: NO RECIPIENT ORGANIZATION RECEIVED MORE THAN $5,000 DURING 2020. X 0 0 X X X X 0 0 0 0 0 0 0 0 0 STEPHEN CHRISTIENSEN FAMILY PRACTICE CHIEF 220093 0 0 0 0 0 25000 0 0 0 245093 0 0 0 PETER KELTERBORN INTERNAL MEDICINE PHYSICIAN 216161 0 0 0 0 0 19000 0 2410 0 237571 0 0 0 ADAM WEAVER DENTAL CHIEF 191780 0 0 0 0 0 19500 0 0 0 211280 0 0 0 GEORGE DELAND PEDIATRICIAN 198701 0 0 0 0 0 12525 0 0 0 211226 0 0 0 BEN STOCKTON FAMILY PRACTICE PHYSICIAN 186694 0 0 0 0 0 17799 0 2860 0 207353 0 0 0 KEVIN KNEPPER CEO/CFO 169998 0 0 0 0 0 25000 0 0 0 194998 0 0 0 NICK MILLER DENTIST 181845 0 0 0 0 0 7274 0 0 0 189119 0 0 0 HAILEY ROSE PEDIATRICS CHIEF 170547 0 0 0 0 0 7204 0 5960 0 183711 0 0 0 TERESA KUHTA PEDIATRICIAN 152649 0 0 0 0 0 19000 0 2410 0 174059 0 0 0 PART I, LINE 1A THE ORGANIZATION RENTS A CONDOMINIUM FROM GEORGE DELAND FOR A PEDIATRIC RESIDENT TO STAY AT. THE MONTHLY RENT PAYMENTS OF $1,150 ARE BELOW FAIR MARKET VALUE. THE ORGANIZATION OFFERS TO PAY $10 PER MONTH FOR ANY EMPLOYEE WITH A GYM MEMBERSHIP. X 15 741411 INVOICE PRICE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS CHAIRED BY THE BOARD CHAIR AND IS RESPONSIBLE FOR MAKING RECOMMENDATIONS ON PROGRAMMATIC AND POLICY ISSUES AT TIMES WHEN THE BOARD IS UNABLE TO MEET. ALL SUCH DECISIONS MUST BE RATIFIED BY THE FULL BOARD AT ITS NEXT MEETING. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE DIRECTOR OF FINANCE AND THE CEO/CFO, THEN PRESENTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE COMPLETED AND REVIEWED ANNUALLY FOR THE BOARD OF DIRECTORS AND KEY EMPLOYEEES. EACH INDIVIDUAL IS REQUIRED TO DISCLOSE ANY PERSONAL INTEREST WHICH THEY MAY HAVE IN ANY MATTER PENDING BEFORE THE ORGANIZATION AND REFRAINS FROM PARTICIPATION IN ANY DECISION ON SUCH MATTER. SUCH REFRAINING MAY TAKE THE FORM OF SIMPLE DISCLOSURE, LEAVING THE ROOM DURING DISCUSSION, NOT PARTICIPATING IN THE DISCUSSION, OR RECUSING ONESELF FROM THE ISSUE ALTOGETHER. FORM 990, PART VI, SECTION B, LINE 15 THE KANIKSU HEALTH SERVICES COMPENSATION MODEL - AS APPROVED BY THE BOARD OF DIRECTORS (BOD) - IS A COMPENSATION SCHEDULE BASED ON THE MOST RECENT NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTER (NACHC) REGION 10 (WASHINGTON, OREGON, IDAHO) COMPENSATION SURVEY BASED ON SIZE OF THE ORGANIZATION - ANNUAL REVENUES, SCOPE OF RESPONSIBILITY, YEARS OF EXPERIENCE AND EDUCATIONAL DEGREES, CERTIFICATIONS, ETC. ALL JOB CATEGORIES (INCLUDING CEO, OTHER OFFICERS AND KEY EMPLOYEES, ALL CLINICAL PROVIDERS AND ALL STAFF) HAVE AN ASSOCIATED COMPENSATION MODEL - THIS APPROACH HAS BEEN APPROVED BY THE BOD. THIS IS USED FOR ALL NEW HIRES AND IS EVALUATED ANNUALLY TO BE SURE THAT THERE IS INTERNAL EQUITY AMONG EMPLOYEES, ETC. THIS COMPENSATION MODEL IS ADJUSTED ANNUALLY BASED ON THE MOST RECENT NACHC DATA - RANGES OF SALARY ARE REVIEWED. IT IS THE GOAL OF KHS TO BE IN THE MEDIAN RANGE OF THE COMPENSATION MODEL - THIS APPROACH HAS BEEN APPROVED BY THE BOD. ANY ADJUSTMENTS MADE TO CURRENT EMPLOYEES ARE BASED ON AVAILABILITY OF BUDGET AS APPROVED BY THE BOD AND ARE DETERMINED BY "RANGE MOVEMENT" FOR STAFF POSITIONS AND FOR MAINTAINING COMPETITIVE RECRUITMENT AND RETENTION FOR PROVIDERS AS COMPARED TO THE OTHER COMMUNITY HEALTH CENTERS IN IDAHO AND IN REGION 10. DECISIONS ARE MADE BY THOSE WITHOUT CONFLICT AND THE DECISIONS ARE DOCUMENTED. THIS PROCESS WAS LAST COMPLETED IN 2019 FOR THE CEO AND 2020 FOR THE REST OF THE OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE CONFLICT OF INTEREST POLICY OR GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE FEDERAL AUDIT CLEARINGHOUSE WEBSITE.