2020-09-28T09:48:40-05:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 1301 WEST 22ND STREET SUITE 1100 OAK BROOK IL 60523 990 2019-01-01 300225826 UNITED COMMUNITY HEALTH CENTER UNIT 7122130109 715 W MILWAUKEE AVE STORM LAKE IA 50588 STEVE CAMPBELL BOARD TREASURER 7122130109 2020-09-27 1 CHRIS MANDERFIELD P01238973 6305738600 2020-09-27 67.137.57.251 2020-09-27 15:44:40 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 882631625C917AF9EBBC1D429A06E96E58975401 2019 2021-01-29 14:40:06Z RICH GEHRIG 715 W MILWAUKEE AVE STORM LAKE IA 50588 4565626 0 X WWW.UCHCSL.COM X 2004 IA IT IS THE MISSION OF UNITED COMMUNITY HEALTH CENTER TO PROVIDE COMPREHENSIVE PRIMARY AND PREVENTIVE CARE TO THE UNINSURED, UNDERINSURED, AND UNDERSERVED OF BUENA VISTA AND SAC COUNTIES. 12 12 44 11 0 0 1347960 1768014 2227985 2796478 701 887 107 247 3576753 4565626 0 0 0 0 2403993 2779013 0 0 0 1030676 1397022 3434669 4176035 142084 389591 4226906 4959673 938313 1281489 3288593 3678184 X IT IS THE MISSION OF UNITED COMMUNITY HEALTH CENTER TO PROVIDE COMPREHENSIVE PRIMARY AND PREVENTIVE CARE TO THE UNINSURED, UNDERINSURED, AND UNDERSERVED OF BUENA VISTA AND SAC COUNTIES. 0 0 1801775 1593420 THE ORGANIZATION PROVIDED PRIMARY AND PREVENTIVE CARE TO A WIDE RANGE OF PATIENTS IN 2019. UNITED COMMUNITY HEALTH CENTER (UCHC) SERVED 4,945 PATIENTS FROM OVER 162 DIFFERENT ZIP CODES THROUGH 16,276 CLINIC VISITS. 48% OF THE PATIENTS SERVED HAVE INCOME UNDER THE 200% FEDERAL POVERTY LINE AND 22% OF PATIENTS ARE UNINSURED. 44% OF PATIENTS ARE BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH. 51% OF PATIENTS ARE HISPANIC, 6% ARE AFRICAN AMERICAN, 8% ARE ASIAN, 31% ARE CAUCASIAN, AND 3% ARE OTHER PACIFIC ISLANDERS. COMMUNITY OUTREACH ACTIVITIES IN 2019 INCLUDED NEIGHBORHOOD OUTREACH PROGRAM, AREA SCHOOL IMMUNIZATION CLINICS, SERVICE ORGANIZATIONS AND LOCAL HEALTH FAIRS. IN OUR MEDICAL CLINIC ELIGIBLE CHILDREN ARE GIVEN FREE VACCINES THROUGH OUR PARTICIPATION IN THE FEDERAL VFC PROGRAM. UCHC OFFERS PRIMARY AND PREVENTIVE MEDICAL CARE, LABORATORY SERVICES. WE ALSO CAN GIVE REFERRALS FOR REDUCED FEE MAMMOGRAMS WITH BUENA VISTA REGIONAL MEDICAL CENTER, AND WORK WITH THE IOWA DEPARTMENT OF PUBLIC HEALTH TO PROVIDE FREE BREAST & CERVICAL CANCER SCREENS, AS WELL AS SCREENS FOR HEART DISEASE. 1082068 956939 OUR DENTAL SERVICES PROGRAM SERVED 1986 PATIENTS IN 4860 DENTAL ENCOUNTERS IN 2019. DENTAL SERVICES OFFERED INCLUDE THE FOLLOWING: DENTAL EXAMINATIONS AND X-RAYS; DENTAL TREATMENTS, FILLINGS, AND EXTRACTIONS; EMERGENCY TREATMENT FOR PAIN, SWELLING, BROKEN TEETH, ETC.; PARTIALS AND DENTURES; ROOT CANAL TREATMENT FOR DISEASES OF THE PULP. 81936 72461 PATIENTS ARE ASSISTED TO OBTAIN LOW COST MEDICATION RANGING FROM 20-80% DISCOUNT THROUGH THE FEDERAL 340B DRUG PROGRAM. PRESCRIPTIONS WERE FILLED THROUGH THIS PROGRAM AT OUR CONTRACT PHARMACIES, HY-VEE AND WALGREENS. IN ADDITION, PATIENTS OBTAINED FREE MEDICATIONS THROUGH OUR PRESCRIPTION ASSISTANCE PROGRAM MANAGED IN THE CLINIC. 195817 173658 OUR BEHAVIOR HEALTH CLINIC OPENED IN 2019 AND SERVED 265 PATIENTS IN 1213 VISITS. SERVICES INCLUDE A COMPREHENSIVE PSYCHIATRIC EVALUATION, DIAGNOSIS, AND DISCUSSION ON INDIVIDUALIZED EVIDENCE-BASED TREATMENT OPTIONS. WE OFFER TREATMENT TO PATIENTS AND FAMILIES FROM CHILDREN TO ADULTS AND TREAT A WIDE RANGE OF CONDITIONS, INCLUDING ANXIETY, DEPRESSION, ADHD, TRAUMA, BIPOLAR DISORDER, SCHIZOPHRENIA, PERSONALITY DISORDERS, AND OTHER BEHAVIORAL HEALTH CONCERNS. 195817 173658 3161596 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 12 0 44 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 IA X X CHELLE ANDERSON 7122130109 715 W MILWAUKEE AVE STORM LAKE IA 50588 ROBERT WHITMORE MD MEDICAL DIRECTOR 40.00 X 191421 0 30506 BRIAN SMITH DDS DENTAL DIRECTOR 40.00 X 172696 0 16150 NATALIE SCHALLER DO MEDICAL DIRECTOR 24.00 X 154833 0 27533 RICH GEHRIG CEO 40.00 X 107216 0 19275 MICHELLE ANDERSON CFO 40.00 X 80544 0 16785 JEFF STARK CHAIRPERSON 1.00 X X 0 0 0 CLARK FORT VICE CHAIRPERSON 1.00 X X 0 0 0 MATT RICKLEFS TREASURER 1.00 X X 0 0 0 LORINDA PETERSON SECRETARY 1.00 X X 0 0 0 PAM BOGUE BOARD MEMBER 1.00 X 0 0 0 RENATO JIMINEZ BOARD MEMBER 1.00 X 0 0 0 STEVE CAMPBELL BOARD MEMBER 1.00 X 0 0 0 JAY DAHLHAUSER BOARD MEMBER 1.00 X 0 0 0 DI DANIELS BOARD MEMBER 1.00 X 0 0 0 MATT BROSTAD BOARD MEMBER 1.00 X 0 0 0 JACKIE DUFFY BOARD MEMBER 1.00 X 0 0 0 706710 0 110249 4 0 1 0 WOODRUFF CONSTRUCTION LLC 1890 KOUNTRY LANE FT DODGE IA 50501 CONSTRUCTION 894519 GREENWAYEHS PO BOX 203658 DALLAS TX 753203658 EHR SOFTWARE, PATIENT BILLING SERVICES 232269 SHIVE HATTERY PO BOX 1599 CEDAR RAPIDS IA 52406 ARCHITECT 188110 REBNORD TECHNOLOGIES 210 SALE BARN ROAD STORM LAKE IA 50588 IT SERVICE AGREEMENT 109584 4 1768014 1768014 CLINIC PROGRAMS 624100 2796478 2796478 2796478 887 887 OTHER REVENUE 900099 247 247 247 4565626 2796478 0 1134 X 223820 167865 55955 1864452 1381721 482731 547108 417035 130073 143633 105930 37703 3993 167 3826 31222 1307 29915 484444 418050 66394 36411 11445 24966 90061 44703 45358 22921 14440 8481 192110 144141 47969 13452 8475 4977 MEDICAL EXPENSES 242781 242781 BAD DEBT 120797 120797 TRAINING & RECRUITMENT 71239 47844 23395 LICENSES AND DUES 66646 33812 32834 20945 1083 19862 4176035 3161596 1014439 0 818219 739397 1177725 318573 197866 357259 2298 2096 9918 66465 4877718 1808848 1815686 3068870 205194 407013 4226906 4959673 360738 713487 577575 568002 938313 1281489 X 3288593 3678184 3288593 3678184 4226906 4959673 389591 0 X X 0 1 X 1 1 1 X 1183967 1247568 1208801 1347960 1768014 6756310 1183967 1247568 1208801 1347960 1768014 6756310 6756310 281 282 405 651 887 2506 20260 59227 90311 107 240 170145 6928961 10135817 0.97510 0.97200 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 1 0 0 1 0 1 0 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO THE IOWA PRIMARY CARE ASSOCIATION. A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING. 281494 281494 3453217 962814 2490403 1143007 846034 296973 3068870 OTHER RECEIVABLES 295213 COST ADJUSTMENT - MEDICAID 110800 COST ADJUSTMENT - MEDICARE 1000 407013 X 4444829 -120797 -120797 4565626 0 4565626 4055238 -120797 -120797 4176035 0 4176035 PART X, LINE 2: THE ORGANIZATION HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)3 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE ORGANIZATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. NO LIABILITY HAS BEEN RECOGNIZED BY THE ORGANIZATION AS A RESULT OF THIS STANDARD. THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBTS -120,797. PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBTS -120,797. X X 0 0 0 0 0 0 0 1 1 0 ROBERT WHITMORE MD MEDICAL DIRECTOR 190921 0 500 0 0 0 12371 0 18135 0 221927 0 0 0 BRIAN SMITH DDS DENTAL DIRECTOR 167696 0 5000 0 0 0 10197 0 5953 0 188846 0 0 0 NATALIE SCHALLER DO MEDICAL DIRECTOR 150333 0 4500 0 0 0 9393 0 18140 0 182366 0 0 0 PART I, LINE 3 THE HEALTH CENTER COMPENSATION AND BENEFITS REPORT FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE COMPENSATION AND BENEFITS SURVEY FROM THE IOWA PRIMARY CARE ASSOCIATION ARE THE RESOURCES USED FOR COMPARABILITY DATA AND SUBSTANTIATION OF THE DELIBERATION AND DECISION. THIS PROCESS IS USED FOR ALL OFFICERS AND KEY EMPLOYEES. THE FINANCE COMMITTEE AND BOARD REVIEWS THE COMPENSATION FOR THE CFO EACH YEAR, INCLUDING 2019. THE CEO'S SALARY WAS APPROVED IN 2009 AS PART OF THE INITIAL CONTRACT. THESE SALARIES ARE ALL APPROVED AS PART OF THE ANNUAL BUDGET BY THE BOARD OF DIRECTORS. PART I, LINE 7 MEDICAL DIRECTORS CAN EARN BONUS FOR HITTING PRODUCTIVITY MARKS AS SPECFIED IN EMPLOYMENT CONTRACT. PART I, LINE 8 DENTAL DIRECTOR WAS PAID A SIGN-ON BONUS AS ACCORDING TO EMPLOYEMENT CONTRACT. RICH GEHRIG CEO 24846 CEO'S DAUGHTER IS AN EMPLOYEE OF THE ORGANIZATION 0 MATT RICKLEFS TREASURER 17100 TREASURER'S WIFE DOES THE SOCIAL MEDIA POSTINGS 0 MATT RICKLEFS TREASURER TREASURER DOES SOME WEBSITE MAINTENANCE 0 FORM 990, PART VI, SECTION A, LINE 2 MATT RICKLEFS AND AND RENATO JIMINEZ - FAMILY RELATIONSHIP - BOARD MEMBERS ARE FAMILY MEMBERS MATT RICKLEFS - BUSINESS RELATIONSHIP - EMPLOYEE OF CENTRAL BANK CLARK FORT - BUSINESS RELATIONSHIP - EMPLOYEE OF STILLE, PIERCE AND PERZBORN JEFF STARK - BUSINESS RELATIONSHIP - RETIRED PARTNER OF HUNZELMAN PUTZIER, CPA LLC STEVE CAMPBELL - BUSINESS RELATIONSHIP - EMPLOYEE OF HUNZELMAN PUTZIER, CPA LLC FORM 990, PART VI, SECTION A, LINE 8B NO COMMITTEES HAVE THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B 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. ONCE A DRAFT IS PREPARED, THE 990 IS INTERNALLY REVIEWED BY THE CEO AND CFO. AFTER THIS REVIEW, THE 990 IS PRESENTED AT THE BOARD MEETING AND TIME IS GIVEN AFTER THE MEETING TO ALLOW FOR BOARD MEMBERS TO ASK QUESTIONS OR MAKE CHANGES TO THE 990 BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE EMPLOYEES, BOARD, AND OFFICERS ("BOARD MEMBERS") ARE TO AVOID EVEN THE APPEARANCE OF A CONFLICT OF INTEREST. ALL BOARD MEMBERS SHALL DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST AT THE EARLIEST PRACTICABLE TIME. NO BOARD MEMBER SHALL VOTE ON ANY MATTER UNDER CONSIDERATION AT A BOARD OR COMMITTEE MEETING IN WHICH SUCH A BOARD MEMBER HAS A CONFLICT OF INTEREST. THE MINUTES OF SUCH MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE AND THAT THE BOARD MEMBER HAVING A CONFLICT OF INTEREST ABSTAINED FROM VOTING. ANY DISCLOSURE OF A PERSON'S INTEREST SHALL APPEAR IN THE MINUTES OF THE MEETING OF THE BOARD OF DIRECTORS OR COMMITTEE THEREOF. THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE CEO, ADDRESSED ANNUALLY AT THE JANUARY BOARD MEETING AND WHEN ALL NEW BOARD MEMBERS JOIN. A BOARD MEMBER WHO HAS A CONFLICT OF INTEREST SHALL NOT TAKE PART IN THE DISCUSSION OF SUCH MATTERS UNLESS ALL PERSONS INTEREST IN SUCH CONTRACT OR TRANSACTION SHALL ALSO HAVE THE RIGHT TO TAKE PART IN THE SAME DISCUSSION OF SUCH MATTER. THE BOARD MEMBERS' PARTICIPATION IN THE DISCUSSION SHALL BE LIMITED TO STATEMENTS CONCERNING THE FAIRNESS AND REASONABLENESS OF SUCH CONTRACT OR TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE HEALTH CENTER COMPENSATION AND BENEFITS REPORT FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE COMPENSTAION AND BENEFITS SURVEY FROM THE IOWA PRIMARY CARE ASSOCIATION ARE THE RESOURCES USED FOR COMPARABILITY DATA AND SUBSTANTIATION OF THE DELIBERATION AND DECISION. THIS PROCESS IS USED FOR ALL OFFICERS AND KEY EMPLOYEES. THE FINANCE COMMITTEE AND BOARD REVIEWS THE COMPENSATION FOR THE CEO EACH YEAR, INCLUDING 2019. THE CFO'S SALARY WAS APPROVED IN 2009 AS PART OF THE INITIAL CONTRACT. THESE SALARIES ARE ALL APPROVED AS PART OF THE ANNUAL BUDGET BY THE BOARD OF DIRECTORS WITHIN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 ALL OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO BE VIEWED AT THE ADIMINISTRATIVE OFFICE AT 715 WEST MILWAUKEE AVE UPON WRITTEN REQUEST. FORM 990, PART IX, LINE 11G CONTRACT SERVICES - BILLING: PROGRAM SERVICE EXPENSES 151,210. MANAGEMENT AND GENERAL EXPENSES 386. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 151,596. CONTRACT SERVICES - CONSULTANTS: PROGRAM SERVICE EXPENSES 130,094. MANAGEMENT AND GENERAL EXPENSES 30,184. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 160,278. CONTRACT SERVICES - LABORATORY: PROGRAM SERVICE EXPENSES 29,542. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,542. CONTRACT SERVICES - OTHER: PROGRAM SERVICE EXPENSES 18,206. MANAGEMENT AND GENERAL EXPENSES 10,572. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,778. CONTRACT SERVICES - INFORMATION TECHNOLOGY: PROGRAM SERVICE EXPENSES 88,998. MANAGEMENT AND GENERAL EXPENSES 25,252. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 114,250. FORM 990, PART XII, LINE 2C NO CHANGE FROM PRIOR YEAR