NEIGHBORHOOD HEALTHSOURCE: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- NEIGHBORHOOD HEALTHSOURCE (EIN 41-1235064)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-13
- IRS object ID
- 202043189349300904
- Schema version
- 2019v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-13T07:15:58-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411235064 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEIGHBORHOOD HEALTHSOURCE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NEIG | BusinessNameControlTxt |
| Phone | 6125889411 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 FREMONT AVENUE N | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554122405 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEVE KNUTSON | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 6125889411 | PhoneNum |
| Signature | 2020-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2020-11-12 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 71.13.38.61 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-12 | IPDt |
| IP Tm | 09:03:36 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9747BB8E0DC0E78824B7C9EDF76D609BB7F00C05 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVE KNUTSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 FREMONT AVENUE N | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554122405 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,449,937 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NEIGHBORHOODHEALTHSOURCE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | THE SCOPE OF OUR PRIMARY MEDICAL SERVICES IS FOCUSED ON MAINTAINING ACCESS TO COMPREHENSIVE PRIMARY AND PREVENTATIVE HEALTHCARE IN ORDER TO IMPROVE THE HEALTH STATUS OF UNDERSERVED AND VULNERABLE POPULATIONS. THE PRIMARY SERVICE AREA IS NORTH AND NORTHEAST MINNEAPOLIS WITH NW HENNEPIN COUNTY AND SOUTHERN ANOKA COUNTY AS SECONDARY SERVICE AREAS. THE TARGET POPULATION INCLUDES LOW-INCOME PEOPLE, BOTH UNINSURED AND THOSE ON MEDICAID. SERVICES ARE PROVIDED AT THREE FREESTANDING CLINICS: FREMONT CLINIC IN NORTH MINNEAPOLIS, CENTRAL AVENUE CLINIC AND SHERIDAN WOMEN & CHILDREN'S CLINIC IN NORTHEAST MINNEAPOLIS. ON-SITE SERVICES INCLUDE PRIMARY CARE, PREVENTION, OUTREACH, OB/GYN, CHRONIC DISEASE, INTERPRETING, AND ASSISTANCE WITH HEALTH CARE PLAN ENROLLMENT. WE PROVIDE REFERRALS AND CARE COORDINATION FOR DENTAL, MENTAL HEALTH AND SUBSTANCE ABUSE, HOSPITAL AND SPECIALTY SERVICES THROUGH PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 91 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,209,249 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,092,386 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,759,129 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,065,544 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $38,722 | PYOtherRevenueAmt |
| CY Other Revenue | $292,007 | CYOtherRevenueAmt |
| PY Total Revenue | $6,007,100 | PYTotalRevenueAmt |
| CY Total Revenue | $6,449,937 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,993,292 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,454,913 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $80,206 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,937,645 | PYOtherExpensesAmt |
| CY Other Expenses | $2,229,386 | CYOtherExpensesAmt |
| PY Total Expenses | $5,930,937 | PYTotalExpensesAmt |
| CY Total Expenses | $6,684,299 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $76,163 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$234,362 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,478,523 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,317,104 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $490,904 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $501,862 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,987,619 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,815,242 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF NEIGHBORHOOD HEALTHSOURCE IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING QUALITY HEALTH CARE SERVICES THAT ARE AFFORDABLE AND ACCESSIBLE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,582,624 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,156,098 | RevenueAmt |
| Desc | PRIMARY MEDICAL CARE:THE SCOPE OF OUR PRIMARY MEDICAL SERVICES IS FOCUSED ON MAINTAINING ACCESS TO COMPREHENSIVE PRIMARY AND PREVENTIVE HEALTHCARE IN ORDER TO IMPROVE THE HEALTH STATUS OF UNDERSERVED AND VULNERABLE POPULATIONS. THE PRIMARY SERVICE AREA IS NORTH AND NORTHEAST MINNEAPOLIS WITH NW HENNEPIN COUNTY AND SOUTHERN ANOKA COUNTY AS SECONDARY SERVICE AREAS. THE TARGET POPULATION INCLUDES LOW-INCOME COMMUNITIES, BOTH UNINSURED AND THOSE ON MEDICAID. SERVICES WERE PROVIDED AT THREE FREESTANDING CLINICS: FREMONT CLINIC IN NORTH MINNEAPOLIS, CENTRAL AVENUE CLINIC AND SHERIDAN CLINIC IN NORTHEAST MINNEAPOLIS. ON-SITE SERVICES INCLUDE PRIMARY CARE, DISEASE AND CANCER PREVENTION, REPRODUCTIVE AND SEXUAL HEALTH EDUCATING, OB/GYN, CHRONIC DISEASE, INTERPRETING, AND ASSISTANCE WITH HEALTH CARE PLAN ENROLLMENT. WE PROVIDE REFERRALS AND CARE COORDINATION FOR DENTAL, MENTAL HEALTH AND SUBSTANCE ABUSE, HOSPITAL AND SPECIALTY SERVICES THROUGH PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS. NHS PROVIDES A VARIETY OF COMMUNITY HEALTH SERVICES IN SUPPORT OF PRIMARY CARE ACTIVITIES INCLUDING HEALTH EDUCATION, CHRONIC DISEASE PREVENTION, CANCER PREVENTION, AND REPRODUCTIVE HEALTH SERVICES. PHYSICIANS, NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, CERTIFIED NURSE-MIDWIVES, CLINICAL AND ADMINISTRATIVE SUPPORT STAFF PROVIDE NHS SERVICES.ON AUGUST 1, 2019, THE HEALTH CENTER ACQUIRED CERTAIN ASSETS AND ASSUMED CERTAIN LIABILITIES OF NORTH METRO PEDIATRICS, P.A. UNDER AN AGREEMENT AND PLAN OF MERGER. NO CONSIDERATION WAS TRANSFERRED UNDER THE TERMS OF THE AGREEMENT. THE HEALTH CENTER RECORDED A CONTRIBUTION OF $59,389 FOR THE DIFFERENCE BETWEEN CASH ACQUIRED AND ACCOUNTS PAYABLE ASSUMED ON THE DATE OF MERGER THAT IS INCLUDED WITHIN CONTRIBUTIONS IN THE ACCOMPANYING STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. THE RESULTS OF THESE OPERATIONS SINCE ACQUISITION ARE INCLUDED IN THE RESULTS OF THE HEALTH CENTER IN THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $228,678 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $201,453 | RevenueAmt |
| Desc | MENTAL HEALTH:WHILE NHS PROVIDES MENTAL HEALTH CARE SERVICES ON SITE FOR MOST PATIENTS, MENTAL HEALTH CARE SERVICES FOR MEDICARE PATIENTS ARE CURRENTLY AVAILABLE THROUGH OFF-SITE REFERRAL TO NORTHPOINT HEALTH AND WELLNESS CENTER LOCATED IN NORTH MINNEAPOLIS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,811,302 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 91 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN PATRIKUS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6122872432 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 FREMONT AVE N | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554122405 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| RAHSHANA PRICE-ISUK | |||||||
| MEDICAL DIRECTOR | 32.00 | Yes (X) | $181,442 | $0 | $34,867 | ||
| MARK VINT | |||||||
| PHYSICIAN | 32.00 | Yes (X) | $158,051 | $0 | $35,454 | ||
| STEVE KNUTSON | |||||||
| EXECUTIVE DIRECTOR | 40.00 | $181,227 | $0 | $17,089 | Yes (X) | ||
| JOHN PATRIKUS | |||||||
| FINANCE DIRECTOR | 40.00 | $106,638 | $0 | $7,277 | Yes (X) | ||
| KIM PERRY | |||||||
| CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| NANCY ALBRECHT | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| COLLEEN COOPER | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| CYNTHIA GAUTHEIR | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| JEFFREY GAUTHIER | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| NOVELLA HOLDER | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| GEORGIA HUGHES | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| BOBBI MORTENSEN | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| MANNY RUBIO | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| STEPHANIE STATZ | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| PETER TATIKIAN | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $627,358 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $94,687 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MCKESSON | |||||
| PO BOX 933027 | ATLANTA | GA | 31193 | MEDICAL SUPPLIES | $148,320 |
| NETRIX IT | |||||
| 1285 CORPORATE CENTER DRIVE SUITE | EAGAN | MN | 55121 | MANAGED IT SERVICES AND EQUIPMENT | $115,826 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $163,400 | FederatedCampaignsAmt |
| Government Grants | $2,728,314 | GovernmentGrantsAmt |
| All Other Contributions | $200,672 | AllOtherContributionsAmt |
| Total Contributions | $3,092,386 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT FEES | 624100 | $2,617,318 | $2,617,318 |
| PHARMACEUTICAL 340B RE | 446110 | $387,921 | $387,921 |
| OTHER MEDICAL SERVICE | 624100 | $60,305 | $60,305 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,065,544 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FUHN DISTRIBUTIONS | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $292,007 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $292,007 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $292,007 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,449,937 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,357,551 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $722,042 | TotalAmt |
| Management And General | $685,940 | ManagementAndGeneralAmt |
| Fundraising | $36,102 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,027,600 | TotalAmt |
| Program Services | $2,102,051 | ProgramServicesAmt |
| Management And General | $891,345 | ManagementAndGeneralAmt |
| Fundraising | $34,204 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,281 | TotalAmt |
| Program Services | $47,319 | ProgramServicesAmt |
| Management And General | $13,456 | ManagementAndGeneralAmt |
| Fundraising | $506 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,385 | TotalAmt |
| Program Services | $251,962 | ProgramServicesAmt |
| Management And General | $98,327 | ManagementAndGeneralAmt |
| Fundraising | $4,096 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,605 | TotalAmt |
| Program Services | $169,831 | ProgramServicesAmt |
| Management And General | $114,476 | ManagementAndGeneralAmt |
| Fundraising | $5,298 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $541 | TotalAmt |
| Management And General | $541 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,917 | TotalAmt |
| Management And General | $29,917 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,779 | TotalAmt |
| Program Services | $207,218 | ProgramServicesAmt |
| Management And General | $87,561 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,869 | TotalAmt |
| Management And General | $18,869 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,495 | TotalAmt |
| Program Services | $14,023 | ProgramServicesAmt |
| Management And General | $110,472 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $378,824 | TotalAmt |
| Program Services | $211,216 | ProgramServicesAmt |
| Management And General | $167,608 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $283,670 | TotalAmt |
| Management And General | $283,670 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,180 | TotalAmt |
| Management And General | $11,180 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,038 | TotalAmt |
| Program Services | $7,948 | ProgramServicesAmt |
| Management And General | $9,090 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,196 | TotalAmt |
| Management And General | $183,196 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,908 | TotalAmt |
| Program Services | $15,716 | ProgramServicesAmt |
| Management And General | $24,192 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROVISION FOR BAD DEBTS | $353,724 | $353,724 | |
| 340 B PROGRAM EXPENSES | $321,555 | $321,555 | |
| LICENSES AND FEES | $67,887 | $42,560 | $25,327 |
| MN CARE/PROVIDER TAX | $47,884 | $47,884 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,919 | TotalAmt |
| Program Services | $18,295 | ProgramServicesAmt |
| Management And General | $37,624 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,684,299 | TotalAmt |
| Program Services | $3,811,302 | ProgramServicesAmt |
| Management And General | $2,792,791 | ManagementAndGeneralAmt |
| Fundraising | $80,206 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,107,487 | BOYAmt |
| EOY | $953,496 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $60,948 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $247,258 | BOYAmt |
| EOY | $255,293 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,474 | BOYAmt |
| EOY | $276,523 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,448 | BOYAmt |
| EOY | $71,440 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,406,627 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,716,931 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,862,744 | BOYAmt |
| EOY | $3,689,696 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,112 | BOYAmt |
| EOY | $9,708 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,478,523 | BOYAmt |
| EOY | $5,317,104 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $374,504 | BOYAmt |
| EOY | $478,094 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,400 | BOYAmt |
| EOY | $23,768 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $490,904 | BOYAmt |
| EOY | $501,862 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,987,619 | BOYAmt |
| EOY | $4,815,242 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,987,619 | BOYAmt |
| EOY | $4,815,242 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,478,523 | BOYAmt |
| EOY | $5,317,104 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$234,362 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,596 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $59,389 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,220,030 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,161,784 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,948,272 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,209,249 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,092,386 | CurrentTaxYearAmt |
| Total | $17,631,721 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,220,030 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,161,784 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,948,272 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,209,249 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,092,386 | CurrentTaxYearAmt |
| Total | $17,631,721 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $17,631,721 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $234 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $316 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23 | CurrentTaxYearMinus2YearsAmt |
| Total | $573 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $17,632,294 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $14,432,231 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,138 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,138 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS DUES TO THE MINNESOTA ASSOCIATION OF COMMUNITY HEALTH CENTERS (MNACHC). SOME OF THOSE MEMBERSHIP COSTS GO TOWARDS LOBBYING AND ADVOCATING. MNACHC IS A NON-PROFIT MEMBERSHIP ORGANIZATION OF MINNESOTA'S FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS). MNACHC WORKS ON BEHALF OF ITS MEMBERS AND THEIR PATIENTS TO PROMOTE THE COST-EFFECTIVE DELIVERY OF AFFORDABLE, QUALITY PRIMARY HEALTH CARE SERVICES. WITH A SPECIAL EMPHASIS ON MEETING THE NEEDS OF LOW INCOME AND MEDICALLY UNDERSERVED POPULATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $801,107 | OtherCostOrOtherBasisAmt |
| Book Value | $801,107 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,473,260 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,646,525 | DepreciationAmt |
| Book Value | $2,826,735 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,132,260 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,070,406 | DepreciationAmt |
| Book Value | $61,854 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,689,696 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $6,158,198 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,596 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $59,389 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $61,985 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,096,213 | RevenueSubtotalAmt |
| Other Revenues Not Included | $353,724 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $353,724 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,449,937 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,330,575 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,330,575 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $353,724 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $353,724 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,684,299 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 353,724. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 353,724. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RAHSHANA PRICE-ISUK | ||||||||||||||
| MEDICAL DIRECTOR | $180,865 | $0 | $0 | $0 | $577 | $0 | $5,654 | $0 | $29,213 | $0 | $216,309 | $0 | $0 | $0 |
| MARK VINT | ||||||||||||||
| PHYSICIAN | $157,502 | $0 | $0 | $0 | $549 | $0 | $4,998 | $0 | $30,456 | $0 | $193,505 | $0 | $0 | $0 |
| STEVE KNUTSON | ||||||||||||||
| EXECUTIVE DIRECTOR | $169,603 | $0 | $10,630 | $0 | $994 | $0 | $5,483 | $0 | $11,606 | $0 | $198,316 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FINANCE DIRECTOR AND EXECUTIVE DIRECTOR REVIEW FORM 990. THE FINANCE DIRECTOR PROVIDES A COPY OF FORM 990 VIA EMAIL WHICH IS REVIEWED BY BOTH THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANY BOARD MEMBERS HAVING AN INTEREST IN AN ITEM OF BUSINESS PRESENTED TO THE BOARD OF DIRECTORS SHALL MAKE PROMPT, FULL AND FRANK DISCLOSURE OF THIS INTEREST PRIOR TO ITS ACTING ON THE ITEM OF BUSINESS. AT THE DISCRETION OF THE BOARD, THE PERSON MAKING THE DECLARATION MAY BE EXCUSED FROM ALL OR A PORTION OF THE RELEVANT DISCUSSION AND VOTING. THE MINUTES OF THE MEETING REFLECT THE DISCLOSURE AND THE VOTING THEREON. THE POLICY IS POSTED ON THE BOARD MEMBER INTRANET AND REVIEWED DURING THE NEW MEMBER ORIENTATION PROCESS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD REVIEWS AND NEGOTIATE WITH POTENTIAL HIRES AND DELIBERATES AND MAKE THE FINAL DECISION FOR THE POSITION OF EXECUTIVE DIRECTOR (CEO). THE EXECUTIVE DIRECTOR MAKES FINAL DECISIONS REGARDING TOP MANAGEMENT OFFICIALS. FOR ALL POSITIONS, SALARY RANGES ARE REVIEWED AND COMPARED TO SALARY SURVEY INFORMATION FOR SIMILAR POSITIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THESE DOCUMENTS CAN BE REQUESTED BY CONTACTING THE ORGANIZATION'S FINANCE DIRECTOR. |
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