2020-02-26T15:03:30-06:00 2019-09-30 470677245 HBE LLP 7140 STEPHANIE LANE PO BOX 23110 LINCOLN NE 685423110 990 2018-10-01 470833378 MIDTOWN HEALTH CENTER MIDT 4023718000 302 W PHILLIP AVE NORFOLK NE 68701 KATHLEEN NORDBY CHIEF EXECUTIVE OFFICER 4023718000 2020-02-20 1 PATRICK A MEYER CPA CFE P00283870 4024234343 2020-02-20 76.79.37.146 2020-02-20 15:15:50 CS P F9B78AEC0ECA0B1DB6488C47F9F34D7F5C721632 D42735FF5BA249E4AFE52A6E9D80CE1366D249EB 2018 2020-09-23 17:36:50Z KATHLEEN NORDBY 302 W PHILLIP AVE NORFOLK NE 68701 6860895 0 X WWW.MIDTOWNHEALTHNE.ORG X 1999 NE PROVIDE MEDICAL, BEHAVIORAL, AND DENTAL SERVICES THAT ARE AFFORDABLE, ACCESSIBLE, AND PATIENT-FOCUSED. 14 14 130 0 0 0 4679085 3647059 3109378 3160017 9770 16640 23389 30224 7821622 6853940 0 0 0 0 3845453 4599323 0 0 56528 2716084 2066275 6561537 6665598 1260085 188342 5464985 5599781 1665040 1611494 3799945 3988287 PROVIDE HIGH QUALITY MEDICAL, BEHAVIORAL, AND DENTAL SERVICES THAT ARE AFFORDABLE, ACCESSIBLE, AND PATIENT-FOCUSED. 0 0 5321260 3160017 MIDTOWN HEALTH CENTER IS A NON-PROFIT 501(C)(3) FEDERALLY QUALIFIED HEALTH CENTER (FQHC). MIDTOWN OFFERS MEDICAL, DENTAL, BEHAVIORAL HEALTH, AND ENABLING SERVICES TO INSURED, UNINSURED, AND UNDER-INSURED INDIVIDUALS. THE NUMBER OF INDIVIDUALS MIDTOWN SERVES CONTINUES TO GROW. IN 2019, WE SAW 7,190 INDIVIDUALS REPRESENTING A 13% INCREASE FROM 2018 FOR A TOTAL OF 24,130 ENCOUNTERS. 36.7% PERCENT OF OUR PATIENTS DID NOT HAVE INSURANCE, 30.3% WERE ENROLLED IN EITHER MEDICAID OR MEDICARE AS THEIR THIRD PARTY PAYOR, 37.3% OF THE PATIENTS HAD INCOME BELOW THE 100% POVERTY GUIDELINE WITH A FULL 81% OF OUR PATIENTS DECLARING THEMSELVES AND THEIR HOUSEHOLD TO BE AT OR BELOW 200% OF POVERTY. 5321260 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 13 0 1 130 1 0 0 0 0 0 1 1 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 4023718000 302 W PHILLIP AVE NORFOLK NE 68701 GRETCHEN FORSELL BOARD CHAIR 2.00 X X 0 0 0 BETTY FROEHLICH VICE CHAIR 2.00 X X 0 0 0 PATRICIA SAMUELS SECRETARY 2.00 X X 0 0 0 SUSAN LUTZ TREASURER 2.00 X X 0 0 0 BRENDA JONES PAST CHAIR 2.00 X 0 0 0 ALAN EHLERS BOARD MEMBER 2.00 X 0 0 0 LEONOR FUHRER BOARD MEMBER 2.00 X 0 0 0 MARY LUHR BOARD MEMBER 2.00 X 0 0 0 BRADLEY JOHNSON BOARD MEMBER 2.00 X 0 0 0 LANCE MORROW BOARD MEMBER 2.00 X 0 0 0 JOE MTIKA BOARD MEMBER 2.00 X 0 0 0 WILL PERRIGAN BOARD MEMBER 2.00 X 0 0 0 MARCUS RIOS BOARD MEMBER 2.00 X 0 0 0 ROBERT SMITH BOARD MEMBER 2.00 X 0 0 0 KAREN WEIDNER BOARD MEMBER 2.00 X 0 0 0 KATHLEEN NORDBY CHIEF EXECUTIVE OFFICER 40.00 X 125577 0 10549 MICHAEL DRAKE CHIEF FINANCIAL OFFICER 24.00 X 59733 0 3448 DR EMILY VUCHETICH PEDIATRICIAN 39.30 X 273064 0 27139 DR RAYMOND HELLER PHYSICIAN 38.90 X 221491 0 8918 DR DAVID SEGER DENTIST 42.30 X 173100 0 7050 DR RACHEL WADE DENTIST 39.10 X 130436 0 3188 DR STACY GIBREAL DENTIST 34.50 X 112379 0 5947 1095780 0 66239 6 0 1 0 0 3099639 547420 804 3647059 PATIENT REVENUE 621110 3006896 3006896 CONTRACT REVENUE 621110 153121 153121 3160017 16640 16640 23398 0 23398 23398 23398 13781 6955 6826 6826 6853940 3160017 0 46864 194983 194983 3725522 2929881 756576 39065 104990 84302 19564 1124 292830 224560 65275 2995 280998 210749 67440 2809 21548 21548 19310 19310 317387 317387 73878 62796 7387 3695 192057 154507 32714 4836 114075 102668 11407 28170 16691 11479 40628 37905 2723 69753 55802 13951 200351 150263 48084 2004 38821 37955 866 DENTAL, MEDICAL & PHARM 533858 533858 ASSOCIATION DUES 217405 201010 16395 LAB FEES 56390 56390 TECHNICAL ASSISTANCE 49500 42125 7375 93144 83101 10043 6665598 5321260 1287810 56528 532154 73968 853811 1562995 395306 393197 373924 433723 8036 52 3863552 751427 3274637 3112125 27117 23721 5464985 5599781 369250 382740 69897 126368 1225893 1102386 1665040 1611494 X 3799945 3988287 3799945 3988287 5464985 5599781 188342 0 X X 0 1 X 1 1 1 X 2150636 2970601 3294277 4679085 3647059 16741658 2150636 2970601 3294277 4679085 3647059 16741658 16741658 20493 19269 27394 28120 16640 111916 3500 5039 8539 16862113 3190241 0.99290 0.99250 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 93269 93269 2925224 352162 2573062 845059 399265 445794 3112125 X 6860895 0 6860895 -6955 -6955 6853940 6672553 6955 6955 6665598 0 6665598 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT ON NET INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES. FOR THE YEAR ENDED SEPTEMBER 30, 2019, THE ORGANIZATION HAD NO TAX LIABILITY ON UNRELATED BUSINESS ACTIVITY. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -6,955. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 6,955. 1 X 0 0 0 0 0 0 0 0 0 DR EMILY VUCHETICH PEDIATRICIAN 201078 0 71986 0 0 0 11208 0 15931 0 300203 0 0 0 DR RAYMOND HELLER PHYSICIAN 220306 0 1185 0 0 0 8869 0 49 0 230409 0 0 0 DR DAVID SEGER DENTIST 171914 0 1186 0 0 0 7001 0 49 0 180150 0 0 0 PART I, LINE 3 THERE IS A STUDY TO COMPARE PAY FROM LIKE ORGANIZATIONS ACROSS THE NATION AND MIDWEST. WE ALSO INCLUDE CONSIDERATION OF THE LOCAL MARKET FOR OTHER HEALTH CARE OR HEALTH DELIVERY AGENCIES LOCALLY THAT WE COMPETE WITH FOR STAFF. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD FOR REVIEW BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C A NEW CONFLICT OF INTEREST POLICY IS DISTRIBUTED AND SIGNED ANNUALLY BY BOARD MEMBERS. THE POLICY CLEARLY STATES THE BOARD MEMBERS RESPONSIBILITY TO DISCLOSE EXISTING KNOWN CONFLICTS AT THAT TIME AND DISCLOSE FUTURE CONFLICTS OR POTENTIAL/PERCEIVED CONFLICTS AT THE TIME ANY NEW SITUATION OR DECISION MAY WARRANT SUCH DISCLOSURE. FORM 990, PART VI, SECTION B, LINE 15 THERE IS A STUDY TO COMPARE PAY FROM LIKE ORGANIZATIONS ACROSS THE NATION AND MIDWEST. WE ALSO INCLUDE CONSIDERATION OF THE LOCAL MARKET FOR OTHER HEALTH CARE OR HEALTH DELIVERY AGENCIES LOCALLY THAT WE COMPETE WITH FOR STAFF. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.