2020-11-16T14:08:24-06:00 2019-12-31 411534805 CARPENTER EVERT & ASSOCIATES LTD 7760 FRANCE AVE S SUITE 940 BLOOMINGTON MN 55435 990 2019-01-01 237113799 SOUTHSIDE COMMUNITY HEALTH SERVICES INC SOUT 6128223282 4243 FOURTH AVENUE SOUTH MINNEAPOLIS MN 55409 ANN CAZABAN EXECUTIVE DIRECTOR 6128223282 2020-11-04 1 NEAL EVERT P00046853 9528310085 2020-11-04 50.244.212.29 2020-11-04 11:18:36 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 2019 2021-01-29 14:40:06Z ANN CAZABAN 4243 FOURTH AVENUE SOUTH MINNEAPOLIS MN 55409 9471713 0 X WWW.SOUTHSIDECHS.ORG X 1971 MN TO PROVIDE HIGH QUALITY HEALTH CARE IN THE COMMUNITIES SERVED. 11 11 124 5 0 0 3226004 4327833 3981110 5096391 0 0 48611 47489 7255725 9471713 0 0 0 0 5354673 5606804 0 0 0 2667123 2468820 8021796 8075624 -766071 1396089 1648579 2181177 2044237 1180746 -395658 1000431 X SOUTHSIDE 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. 0 0 3728860 MEDICAL: 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. 3230685 DENTAL: 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 2018, SOUTHSIDE MEDICAL AND DENTAL SERVED 3,482 UNINSURED ADULTS, 507 UNINSURED CHILDREN AND 5,007 PATIENTS ON MEDICAID. 227350 OUTREACH: 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. 7186895 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7 0 1 124 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 1 1 1 1 0 MN X X THE ORGANIZATION 6128229030 4243 FOURTH AVENUE SOUTH MINNEAPOLIS MN 55409 KALEECA BIBLE DIRECTOR 1.00 X 0 0 0 BRIAN OSBERG CHAIR 1.00 X X 0 0 0 JIM GALLAGHER SECRETARY 1.00 X X 0 0 0 KRISTY GRAUME DIRECTOR 1.00 X 0 0 0 MICHELLE EVANS DIRECTOR 1.00 X 0 0 0 PATRICK LYTLE VICE CHAIR 1.00 X X 0 0 0 SHAUN ZEIG TREASURER 1.00 X X 0 0 0 ANGEL EVEN DIRECTOR 1.00 X 0 0 0 EMILY ANDERSON DIRECTOR 1.00 X 0 0 0 IRENE PEREZ DIRECTOR 1.00 X 0 0 0 EDGAR ARAIZ DIRECTOR 1.00 X 0 0 0 ANN CAZABAN EXECUTIVE DIRECTOR 40.00 X 123097 0 4726 JENNY LEE FINANCE DIRECTOR 40.00 X 82778 0 3516 BRIAN QUINLAN DENTAL DIRECTOR 40.00 X 154980 0 8182 LIZA ORTIZ MEDICAL DIRECTOR 40.00 X 164544 0 15843 JAYME NOESKE DENTIST 40.00 X 124992 0 7283 AUGUSTINE EVBAKHARE NURSE PRACTITIONER 40.00 X 111078 0 5365 MOHUIDDIN QUADRI DENTIST 40.00 X 111095 0 14240 872564 0 59155 6 0 1 0 0 4143758 184075 4327833 PATIENT FEES 621400 5096391 5096391 5096391 MISCELLANEOUS REVENUE 621400 47489 47489 47489 9471713 5096391 0 47489 557666 509149 48517 4424936 4041723 383213 210151 191954 18197 414051 378175 35876 3838 3838 26224 26224 532708 422724 109984 300833 224613 76220 295614 259628 35986 233257 170682 62575 33929 15513 18416 30935 30935 189089 172705 16384 15050 13746 1304 BAD DEBTS 440283 440283 SUPPLIES 309542 309542 OTHER EXPENSE 21714 13343 8371 MEMBERSHIP AND DUES 18104 5415 12689 17700 17700 8075624 7186895 888729 0 309610 95095 106578 666190 709634 2100 7288 3478939 2430872 881912 1048067 3282 0 1648579 2181177 1308770 630902 731821 547240 3646 2604 2044237 1180746 X -420658 1000431 25000 0 -395658 1000431 1648579 2181177 1396089 0 X 0 1 X 1 1 1 X 2064197 2692316 3012303 3226004 4327833 15322653 4422713 4682713 3941378 3981110 5096391 22124305 6486910 7375029 6953681 7207114 9424224 37446958 0 0 0 37446958 22 37 433 492 22 37 433 492 11167 88492 88365 48611 47489 284124 6498099 7463558 7042479 7255725 9471713 37731574 0.99250 0.99290 0.00000 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2015 AMOUNT: $ 11,167. 2016 AMOUNT: $ 88,492. 2017 AMOUNT: $ 88,365. 2018 AMOUNT: $ 48,611. 2019 AMOUNT: $ 47,489. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 130543 130543 1132776 795856 336920 315603 315603 0 1900017 1319413 580604 1048067 REFUNDABLE ADVANCES 2604 2604 X 9471713 0 9471713 0 9471713 8075624 0 8075624 0 8075624 PART X, LINE 2: THE 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. 0 0 0 0 0 0 0 0 0 BRIAN QUINLAN DENTAL DIRECTOR 154980 0 0 0 0 0 0 0 8182 0 163162 0 0 0 LIZA ORTIZ MEDICAL DIRECTOR 164544 0 0 0 0 0 0 0 15843 0 180387 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B LINE 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 12C CONFLICT 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 15 THE 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 19 NO OTHER DOCUMENTS AVAILABLE TO THE PUBLIC.