NEIGHBORHOOD HEALTHSOURCE: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
NEIGHBORHOOD HEALTHSOURCE (EIN 41-1235064)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-14
IRS object ID
201943189349302614
Schema version
2018v3.1
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

FieldValueIRS element (for citing)
Return2019-11-14T09:43:02-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11502 LONDON ROAD SUITE 200AddressLine1Txt
CityDULUTHCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55812ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411235064EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NEIGHBORHOOD HEALTHSOURCEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNEIGBusinessNameControlTxt
Phone6125889411PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 FREMONT AVENUE NAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554122405ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEVE KNUTSONPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone6125889411PhoneNum
Signature2019-11-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL J PETERSON CPAPreparerPersonNm
PTINP01833529PTIN
Phone2187224705PhoneNum
Preparation2019-11-08PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address4.30.113.218IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-08IPDt
IP Tm09:04:52IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdE433C82216CF4B1B7B2D83A781BC20530CAF3EA5AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSTEVE KNUTSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 FREMONT AVENUE NAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554122405ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$6,011,054GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.NEIGHBORHOODHEALTHSOURCE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1970FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTHE 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 Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee92TotalEmployeeCnt
Total Volunteers40TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,948,272PYContributionsGrantsAmt
CY Contributions Grants$3,209,249CYContributionsGrantsAmt
PY Program Service Revenue$2,954,256PYProgramServiceRevenueAmt
CY Program Service Revenue$2,759,129CYProgramServiceRevenueAmt
PY Investment Income$570PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$143,254PYOtherRevenueAmt
CY Other Revenue$38,722CYOtherRevenueAmt
PY Total Revenue$6,046,352PYTotalRevenueAmt
CY Total Revenue$6,007,100CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,949,572PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,993,292CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$76,089CYTotalFundraisingExpenseAmt
PY Other Expenses$1,975,023PYOtherExpensesAmt
CY Other Expenses$1,937,645CYOtherExpensesAmt
PY Total Expenses$5,924,595PYTotalExpensesAmt
CY Total Expenses$5,930,937CYTotalExpensesAmt
PY Revenues Less Expenses$121,757PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$76,163CYRevenuesLessExpensesAmt
Total Assets BOY$5,336,731TotalAssetsBOYAmt
Total Assets EOY$5,478,523TotalAssetsEOYAmt
Total Liabilities BOY$425,616TotalLiabilitiesBOYAmt
Total Liabilities EOY$490,904TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,911,115NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,987,619NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,909,727ExpenseAmt
Grant$0GrantAmt
Revenue$2,631,332RevenueAmt
DescPRIMARY 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.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$249,557ExpenseAmt
Grant$0GrantAmt
Revenue$167,957RevenueAmt
DescMENTAL 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
FieldValueIRS element (for citing)
Total Program Service Expenses$4,159,284TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee92EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN PATRIKUSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6122872432PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 FREMONT AVE NAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554122405ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
NANCY ALBRECHT
DIRECTOR1.00Yes (X)$0$0$0
MARLINE BLAKE
DIRECTOR1.00Yes (X)$0$0$0
COLLEEN COOPER
DIRECTOR1.00Yes (X)$0$0$0
CYNTHIA GAUTHEIR
DIRECTOR1.00Yes (X)$0$0$0
VICKIE S GILFILLIAN-BENNETT
DIRECTOR (THRU MARCH)1.00Yes (X)$0$0$0
NOVELLA HOLDER
DIRECTOR1.00Yes (X)$0$0$0
GEORGIA HUGHES
DIRECTOR1.00Yes (X)$0$0$0
MANNY RUBIO
DIRECTOR1.00Yes (X)$0$0$0
STEPHANIE STATZ
DIRECTOR1.00Yes (X)$0$0$0
KIM PERRY
CHAIR1.00Yes (X)$0$0$0
ANDREW SENN
CHAIR (THRU JUNE)1.00Yes (X)$0$0$0
STEVE KNUTSON
EXECUTIVE DIRECTOR40.00$172,528$0$32,929Yes (X)
JOHN PATRIKUS
FINANCE DIRECTOR40.00$103,055$0$7,224Yes (X)
RAHSHANA PRICE-ISUK
MEDICAL DIRECTOR32.00$176,616$0$35,340Yes (X)
MARK VINT
PHYSICIAN32.00$154,727$0$34,541Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$606,926TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$110,034TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MCKESSONBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 933027AddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP31193ZIPCd
FieldValueIRS element (for citing)
ServicesMEDICAL SUPPLIESServicesDesc
Compensation$103,150CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Federated Campaigns$163,400FederatedCampaignsAmt
Fundraising$26,065FundraisingAmt
Government Grants$2,960,403GovernmentGrantsAmt
All Other Contributions$59,381AllOtherContributionsAmt
Total Contributions$3,209,249TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT FEES624100$2,417,844$2,417,844
OTHER MEDICAL SERVICE624100$282,600$282,600
PHARMACEUTICAL 340B RE446110$58,685$58,685
FieldValueIRS element (for citing)
Total Program Service Revenue$2,759,129TotalProgramServiceRevenueAmt
Fundraising Gross Income$2,516FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$26,065ContriRptFundraisingEventAmt
Fundraising Direct Expenses$3,954FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,438TotalRevenueColumnAmt
Exclusion-$1,438ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
FUHN DISTRIBUTIONS624100$23,160$23,160
EHR INCENTIVE624100$17,000$17,000
FieldValueIRS element (for citing)
Other Revenue Total$40,160OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,007,100TotalRevenueColumnAmt
Related Or Exempt Func Income$2,799,289RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$1,438ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$315,736TotalAmt
Management And General$305,464ManagementAndGeneralAmt
Fundraising$10,272FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,970,850TotalAmt
Program Services$2,397,072ProgramServicesAmt
Management And General$521,127ManagementAndGeneralAmt
Fundraising$52,651FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$65,527TotalAmt
Program Services$47,792ProgramServicesAmt
Management And General$16,480ManagementAndGeneralAmt
Fundraising$1,255FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$377,915TotalAmt
Program Services$280,784ProgramServicesAmt
Management And General$90,260ManagementAndGeneralAmt
Fundraising$6,871FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$263,264TotalAmt
Program Services$192,012ProgramServicesAmt
Management And General$66,212ManagementAndGeneralAmt
Fundraising$5,040FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,033TotalAmt
Program Services$1,033ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$30,574TotalAmt
Management And General$30,574ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$266,543TotalAmt
Program Services$205,775ProgramServicesAmt
Management And General$60,768ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$8,939TotalAmt
Management And General$8,939ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$126,580TotalAmt
Program Services$47,786ProgramServicesAmt
Management And General$78,794ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$317,390TotalAmt
Program Services$167,115ProgramServicesAmt
Management And General$150,275ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$265,175TotalAmt
Program Services$146,788ProgramServicesAmt
Management And General$118,387ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,879TotalAmt
Program Services$268ProgramServicesAmt
Management And General$6,611ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$15,566TotalAmt
Program Services$9,173ProgramServicesAmt
Management And General$6,393ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$189,162TotalAmt
Management And General$189,162ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$35,372TotalAmt
Program Services$9,355ProgramServicesAmt
Management And General$26,017ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROVISION FOR BAD DEBTS$297,060$297,060
340 B PROGRAM EXPENSES$283,685$283,685
MN CARE/PROVIDER TAX$43,971$43,971
DUES AND SUBSCRIPTIONS$12,025$200$11,825

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$37,691TotalAmt
Program Services$29,415ProgramServicesAmt
Management And General$8,276ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,930,937TotalAmt
Program Services$4,159,284ProgramServicesAmt
Management And General$1,695,564ManagementAndGeneralAmt
Fundraising$76,089FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$787,634BOYAmt
EOY$1,107,487EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$98,454BOYAmt
EOY$247,258EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$368,835BOYAmt
EOY$232,474EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$23,131BOYAmt
EOY$21,448EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,396,479LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,533,735LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,051,906BOYAmt
EOY$3,862,744EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$6,771BOYAmt
EOY$7,112EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,336,731BOYAmt
EOY$5,478,523EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$411,565BOYAmt
EOY$374,504EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$14,051BOYAmt
EOY$116,400EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$425,616BOYAmt
EOY$490,904EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,911,115BOYAmt
EOY$4,987,619EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,911,115BOYAmt
EOY$4,987,619EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,336,731BOYAmt
EOY$5,478,523EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$76,163ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$341NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,259,313CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,220,030CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,161,784CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,948,272CurrentTaxYearMinus1YearAmt
Current Tax Year$3,209,249CurrentTaxYearAmt
Total$17,798,648TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,259,313CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,220,030CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,161,784CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,948,272CurrentTaxYearMinus1YearAmt
Current Tax Year$3,209,249CurrentTaxYearAmt
Total$17,798,648TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$17,798,648PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$90CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$234CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$316CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$23CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$663TotalAmt
FieldValueIRS element (for citing)
Total Support$17,799,311TotalSupportAmt
Gross Receipts Rltd Activities$13,857,789GrossReceiptsRltdActivitiesAmt
Public Support CY1701.00000PublicSupportCY170Pct
Public Support PY1700.99990PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$2,850OtherActivitiesAmt
Total Lobbying Expenditures$2,850TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE 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

FieldValueIRS element (for citing)
Other Cost Or Other Basis$801,107OtherCostOrOtherBasisAmt
Book Value$801,107BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,473,260OtherCostOrOtherBasisAmt
Depreciation$1,473,024DepreciationAmt
Book Value$3,000,236BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,122,112OtherCostOrOtherBasisAmt
Depreciation$1,060,711DepreciationAmt
Book Value$61,401BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,862,744TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$5,719,891TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$341NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$5,556DonatedServicesAndUseFcltsAmt
Other Revenue$3,954OtherRevenueAmt
Revenue Not Reported$9,851RevenueNotReportedAmt
Revenue Subtotal$5,710,040RevenueSubtotalAmt
Other Revenues Not Included$297,060OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$297,060RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$6,007,100TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$5,643,387TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$5,556DonatedServicesUseFcltsAmt
Other Expenses Included$3,954OtherExpensesIncludedAmt
Expenses Not Reported$9,510ExpensesNotReportedAmt
Expenses Subtotal$5,633,877ExpensesSubtotalAmt
Other Expenses Not Included$297,060OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$297,060ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$5,930,937TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSE 3,954.
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 297,060.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSE 3,954.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 297,060.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1ANNUAL GALAEvent1Nm
Gross Receipts Event1$28,581GrossReceiptsEvent1Amt
Charitable Contri Event1$26,065CharitableContriEvent1Amt
Gross Revenue Event1$2,516GrossRevenueEvent1Amt
Food And Beverage Event1$3,091FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$863OtherDirectExpensesEvent1Amt
Gross Receipts Total$28,581GrossReceiptsTotalAmt
Charitable Contributions Tot$26,065CharitableContributionsTotAmt
Gross Revenue Total Events$2,516GrossRevenueTotalEventsAmt
Food And Beverage Total Events$3,091FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$863OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$3,954DirectExpenseSummaryEventsAmt
Net Income Summary-$1,438NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
STEVE KNUTSON
EXECUTIVE DIRECTOR$159,869$0$12,086$0$573$0$5,362$0$27,567$0$205,457$0$0$0
RAHSHANA PRICE-ISUK
MEDICAL DIRECTOR$176,459$0$0$0$157$0$5,486$0$29,854$0$211,956$0$0$0
MARK VINT
PHYSICIAN$154,598$0$0$0$129$0$4,860$0$29,681$0$189,268$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE 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 12CANY 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 15THE 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 19THE 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.
FORM 990, PART XII, LINE 2CTHE FINANCE COMMITTEE AND BOARD OF DIRECTORS REVIEW THE AUDITED FINANCIAL STATEMENTS AND HAVE OVERSIGHT OF THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR.

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