2020-06-30T12:13:25-05:00 2019-12-31 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2019-01-01 412056863 BLUESTEM HEALTH BLUE 4024761640 1021 NORTH 27TH STREET LINCOLN NE 68503 BRAD MEYER CHIEF EXECUTIVE OFFICER 4024761640 2020-06-30 1 WENDY R COOLEY P01523804 4023302660 209.34.201.180 2020-06-30 11:17:17 CD P 6EA686D05799596D5B36C7D6BA61CBFF235CAD22 5D066E2939FE45487034BD10C4A0DC94BE27FEF9 2019 2021-01-29 14:40:06Z BRAD MEYER 1021 NORTH 27TH STREET LINCOLN NE 68503 14192659 0 X WWW.BLUESTEMLINCOLN.COM X 2002 NE TO BE A TRUSTED RESOURCE FOR EXCELLENT MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES. 11 11 183 20 0 0 2735675 2792875 8272935 11383800 18177 12923 686 3061 11027473 14192659 0 0 0 0 6730857 8833674 0 0 0 4013884 5085273 10744741 13918947 282732 273712 5258287 5979739 808136 1255876 4450151 4723863 X TO BE A TRUSTED RESOURCE FOR EXCELLENT MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES. 0 0 5310342 6142270 MEDICAL SERVICES - BLUESTEM HEALTH PROVIDES COMPREHENSIVE MEDICAL SERVICES TO ITS PATIENTS. OUR PROVIDER STAFF INCLUDES FAMILY PRACTICE PHYSICIANS, NURSE PRACTITIONERS, A PHYSICIAN ASSISTANT, PSYCHIATRIC NURSE PRACTITIONER & BEHAVIORAL HEALTH THERAPISTS, AND VOLUNTEER SPECIALTY PHYSICIANS. 1440697 1083160 THE HEALTH 360 CLINIC, A PARTNERSHIP BETWEEN LUTHERAN FAMILY SERVICES OF NEBRASKA AND BLUESTEM HEALTH, PROVIDES AN AFFORDABLE, HOLISTIC APPROACH TO CARE, ESPECIALLY FOR THE MOST VULNERABLE. SERVICES AT HEALTH 360 ARE PROVIDED ON A SLIDING FEE SCALE THAT OFFERS REDUCED PRICES ON OFFICE VISITS AND SERVICES BASED ON INCOME. 1195097 1099059 DENTAL SERVICES - BLUESTEM HEALTH OFFERS PREVENTATIVE DENTAL SERVICES INCLUDING: X-RAYS, EXAMS, CLEANINGS, FILLINGS, AND EXTRACTIONS. 3366533 3060715 OTHER SERVICES - COMMUNITY SERVICES, MEDICAL RECORDS, LAB, X-RAY, PHARMACY 3366533 3060715 11312669 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 1 183 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 1 1 1 1 1 1 0 X JACQUE FANNING CHIEF FINANCIAL OFFICER 4024705421 1021 N 27TH STREET LINCOLN NE 68503 CHARLOTTE BURKE CHAIR 2.00 X X 0 0 0 NICK SASSAMAN VICE CHAIR 2.00 X X 0 0 0 ROY RIVERA SECRETARY THRU 11/2019 2.00 X X 0 0 0 DANNY MURRAY TREASURER 2.00 X X 0 0 0 NIKI STEHLIK DIRECTOR 1.00 X 0 0 0 CHRISTI WILLIAMS DIRECTOR 1.00 X 0 0 0 DR MICHAEL FERRIS DIRECTOR 1.00 X 0 0 0 ALEXANDRA SVOBODA DIRECTOR THRU 2/2019 1.00 X 0 0 0 BETSY TONNIGES DIRECTOR 1.00 X 0 0 0 AMY LEHMAN-TIMM DIRECTOR 1.00 X 0 0 0 ANDREW SCHILL DIRECTOR 1.00 X 0 0 0 VINCENT PAUL DIRECTOR 1.00 X 0 0 0 JULIA STUBBLEFIELD DIRECTOR 1.00 X 0 0 0 BRAD MEYER CEO 40.00 X 171457 0 17316 JACQUE FANNING CFO 40.00 X 109092 0 16097 DR MICHAEL ISRAEL PHYSICIAN 40.00 X 241068 0 38771 DR CHARLES KRESHEL PHYSICIAN 40.00 X 142545 0 381 DR HORACIO ALVAREZ RAMIREZ PHYSICIAN 40.00 X 196087 0 14765 DR JOHN KUVETAKIS PHYSICIAN 40.00 X 129483 0 22775 DR ARATHI REDDY DENTIST 38.00 X 177524 0 6775 1167256 0 116880 11 0 1 0 RPH INNOVATIONS LLC 1401 BRANDING LANE STE 360 DOWNERS GROVE IL 60515 340B PROGRAM MANAGEMENT 273457 NEXTGEN HEALTHCARE 18111 VON KARMAN AVE STE 800 IRVINE CA 92612 EHR SOFTWARE SUPPORT 186570 LABCORP PO BOX 12140 BURLINGTON NC 27216 PATIENT LAB SERVICES 132336 LUTHERAN FAMILY SERVICES 124 S 24TH STREET STE 230 OMAHA NE 68102 CONTRACTED BEHAVIORAL HEALTH CONSULTANTS 129554 ELEANOR CREATIVE 701 P STREET STE 201 LINCOLN NE 68508 MARKETING 107726 5 2680142 112733 2792875 MEDICAID 621400 3646860 3646860 PHARMACY 621400 3078415 3078415 PATIENT FEES 621400 3017979 3017979 MEDICARE 621400 1102385 1102385 CASE MANAGEMENT FEES 621400 538161 538161 11383800 12923 12923 1657 0 1657 1657 1657 MISCELLANEOUS REVENUE 900099 1404 1404 1404 14192659 11385204 0 14580 313962 313962 6984137 6048223 935914 129404 103954 25450 869622 704098 165524 536549 449703 86846 49602 29852 19750 166673 15031 151642 1331980 1137242 194738 141028 141028 504748 340017 164731 822052 612102 209950 73783 44396 29387 4374 4374 200324 157511 42813 49803 28081 21722 UBI TAXES 73 73 MEDICAL SUPPLIES 559058 559058 BAD DEBT EXPENSE 394352 394352 MEDICATIONS 334621 334621 452802 354355 98447 13918947 11312669 2606278 0 2700 3700 2477029 2596437 614055 822663 846714 835864 124184 192329 165354 142095 3248676 2140002 893260 1108674 134991 277977 5258287 5979739 808136 1250376 5500 808136 1255876 X 4450151 4723863 4450151 4723863 5258287 5979739 273712 0 X X 0 1 X 1 1 1 X 2719081 2836608 2466754 2735675 2792875 13550993 2719081 2836608 2466754 2735675 2792875 13550993 13550993 1621 1961 10439 18177 14580 46778 534 688 782 686 1404 4094 13601865 36249759 0.99630 0.99710 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1407833 711204 696629 1824825 1428798 396027 16018 16018 1108674 X 13799267 960 960 13798307 394352 394352 14192659 13525555 960 960 13524595 394352 394352 13918947 PART X, LINE 2: THE HEALTH CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HEALTH CENTER ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE HEALTH CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2019 AND 2018, THE HEALTH CENTER HAD NO UNCERTAIN TAX POSITIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 394,352. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 394,352. X X 0 0 0 0 0 0 0 1 0 BRAD MEYER CEO 157797 0 13600 0 60 0 6423 0 10893 0 188773 0 0 0 DR MICHAEL ISRAEL PHYSICIAN 197005 0 44015 0 48 0 8804 0 29967 0 279839 0 0 0 DR HORACIO ALVAREZ RAMIREZ PHYSICIAN 193302 0 2785 0 0 0 5393 0 9372 0 210852 0 0 0 DR JOHN KUVETAKIS PHYSICIAN 129483 0 0 0 0 0 5042 0 17733 0 152258 0 0 0 DR ARATHI REDDY DENTIST 177524 0 0 0 0 0 6775 0 0 0 184299 0 0 0 PART I, LINE 7 BLUESTEM HEALTH IS PART OF AN ORGANIZATION THAT STRIVES TO SAVE INSURANCE COMPANIES MONEY WHILE ALSO IMPROVING THE HEALTH OF PATIENTS. THE ORGANIZATION SETS OVERALL MEASURES/GOALS FOR THE HEALTH CENTER TO ACHIEVE. BASED ON HOW WELL THE HEALTH CENTER PERFORMS AND THE OUTCOMES IT PRODUCES FOR PATIENTS, THE HEALTH CENTER RECEIVES INCENTIVE PAYMENTS. THESE PAYMENTS ARE THEN PAID OUT TO THE PROVIDERS AND SUPPORT STAFF WHO HELPED THE HEALTH CENTER PERFORM AT AND ABOVE THEIR GOALS. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE COMMITTEE REVIEWS THE FORM 990 AND PRESENTS IT TO THE BOARD OF DIRECTORS WITH A RECOMMENDATION FOR APPROVAL BEFORE IT IS SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY RESPONSIBLE PERSONS AND EACH RESPONSIBLE PERSON MUST ANNUALLY COMPLETE A DISCLOSURE FORM IDENTIFYING ANY POSSIBLE CONFLICTS OF INTEREST. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND UPDATED AT THE ANNUAL MEETING EACH YEAR. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS OF BLUESTEM HEALTH SETS THE COMPENSATION FOR THE CHEIF EXECUTIVE OFFICER AND OTHER KEY EMPLOYEES. THEY REVIEW AN ANNUAL SALARY SURVEY CONDUCTED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. THE BOARD ALSO REVIEWS THE SALARY SURVEY FOR NONPROFIT ORGANIZATIONS CONDUCTED BY THE MEDICAL GROUP MANAGEMENT ASSOCIATION. DECISIONS FOR COMPENSATION ARE BASED ON A PERSON'S EXPERIENCE, SKILLS AND EDUCATIONAL LEVEL. THE SALARIES ARE APPROVED WITH A MAJORITY VOTE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 BLUESTEM HEALTH MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS OF BLUESTEM HEALTH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.