2019-08-05T10:35:40-05:00 2018-12-31 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2018-01-01 412056863 BLUESTEM HEALTH BLUE 4024761640 1021 NORTH 27TH STREET LINCOLN NE 68503 BRAD MEYER CHIEF EXECUTIVE OFFICER 4024761640 2019-07-30 1 WENDY R COOLEY P01523804 4023302660 209.34.201.180 2019-07-30 15:16:15 CD P 06718D1991FB6EEBEB7ECD4F00D4AA79CF05A929 5D066E2939FE45487034BD10C4A0DC94BE27FEF9 2018 2019-02-21 02:37:17Z BRAD MEYER 1021 NORTH 27TH STREET LINCOLN NE 68503 11027473 0 X WWW.BLUESTEMLINCOLN.COM X 2002 NE TO BE A TRUSTED RESOURCE FOR EXCELLENT MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES. 10 10 158 20 0 8000 2466754 2735675 7826381 8272935 10610 18177 782 686 10304527 11027473 0 0 0 0 6027009 6730857 0 0 0 3718285 4013884 9745294 10744741 559233 282732 5031890 5258287 864471 808136 4167419 4450151 X TO BE A TRUSTED RESOURCE FOR EXCELLENT MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES. 0 0 2550685 2407725 MEDICAL SERVICES - BLUESTEM HEALTH PROVIDES COMPREHENSIVE MEDICAL SERVICES TO ITS PATIENTS. OUR PROVIDER STAFF INCLUDES FAMILY PRACTICE PHYSICIANS, NURSE PRACTITIONERS, A PHYSICIAN ASSISTANT, PSYCHIATRIC NURSE PRACTITIONER & BEHAVIORAL HEALTH THERAPISTS, AND VOLUNTEER SPECIALTY PHYSICIANS. 1537984 778456 THE HEALTH 360 CLINIC, A PARTNERSHIP BETWEEN LUTHERAN FAMILY SERVICES OF NEBRASKA AND BLUESTEM HEALTH, PROVIDES AN AFFORDABLE, HOLISTIC APPROACH TO CARE, ESPECIALLY FOR THE MOST VULNERABLE. SERVICES AT HEALTH 360 ARE PROVIDED ON A SLIDING FEE SCALE THAT OFFERS REDUCED PRICES ON OFFICE VISITS AND SERVICES BASED ON INCOME. 1080319 1019770 DENTAL SERVICES - BLUESTEM HEALTH OFFERS PREVENTATIVE DENTAL SERVICES INCLUDING: X-RAYS, EXAMS, CLEANINGS, FILLINGS, AND EXTRACTIONS. 3678602 4067670 OTHER SERVICES - COMMUNITY SERVICES, MEDICAL RECORDS, LAB, X-RAY, PHARMACY 3678602 4067670 8847590 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 1 158 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JACQUE FANNING CHIEF FINANCIAL OFFICER 4024705421 1021 N 27TH STREET LINCOLN NE 68503 CHARLOTTE BURKE CHAIR 2.00 X X 0 0 0 NICK SASSAMAN VICE CHAIR 2.00 X X 0 0 0 ROY RIVERA SECRETARY 2.00 X X 0 0 0 DANNY MURRAY TREASURER 2.00 X X 0 0 0 DANAY KALKOWSKI PAST CHAIR THRU 12/2018 2.00 X X 0 0 0 NIKI STEHLIK DIRECTOR 1.00 X 0 0 0 MARYANN PONTES DIRECTOR THRU 10/2018 1.00 X 0 0 0 CHRISTI WILLIAMS DIRECTOR 1.00 X 0 0 0 DR MICHAEL FERRIS DIRECTOR 1.00 X 0 0 0 ALEXANDRA SVOBODA DIRECTOR 1.00 X 0 0 0 BETSY TONNIGES DIRECTOR 1.00 X 0 0 0 AMY LEHMAN-TIMM DIRECTOR 1.00 X 0 0 0 BRAD MEYER CEO 40.00 X 135419 0 11270 JACQUE FANNING CFO 40.00 X 94380 0 6561 DR HORACIO ALVAREZ RAMIREZ PHYSICIAN 40.00 X 196087 0 14766 DR MICHAEL ISREAL PHYSICIAN 40.00 X 218540 0 34669 DR ARATHI REDDY DENTIST 38.00 X 165988 0 6639 DR DERRICK ANDERSON PHYSICIAN 40.00 X 216306 0 16165 DR SARAH CASTILLO PHYSICIAN 40.00 X 168177 0 4054 1194897 0 94124 9 0 1 0 0 2636788 98887 2735675 MEDICAID 621400 2583485 2583485 PHARMACY 621400 2309967 2309967 PATIENT FEES 621400 2191483 2191483 MEDICARE 621400 836175 836175 CASE MANAGEMENT FEES 621400 351825 351825 8272935 18177 18177 MISCELLANEOUS REVENUE 900099 686 686 686 11027473 8273621 0 18177 X 247630 247630 5344810 4663293 681517 105576 92791 12785 630390 521557 108833 402451 335684 66767 45981 30973 15008 60032 4338 55694 1200114 993418 206696 117616 117616 369008 248197 120811 709323 604957 104366 83195 34297 48898 3020 3020 181383 148378 33005 46201 27343 18858 MEDICAL SUPPLIES 490643 490643 OTHER PROGRAM SERVICES 212292 212292 MEDICATIONS 202220 202220 BAD DEBT EXPENSE 154970 154970 137886 82239 55647 10744741 8847590 1897151 0 2500 2700 2549245 2477029 553892 614055 709554 846714 106393 124184 90190 165354 2832937 1939677 885125 893260 134991 134991 5031890 5258287 864471 808136 864471 808136 X 4167419 4450151 4167419 4450151 5031890 5258287 282732 0 X X 0 1 X 1 1 1 X 2213828 2719081 2836608 2466754 2735675 12971946 2213828 2719081 2836608 2466754 2735675 12971946 12971946 1684 1621 1961 10439 18177 33882 1550 534 688 782 686 4240 13010068 28479832 0.99710 0.99830 X 1231510 648699 582811 1601427 1290978 310449 893260 X 10878979 6476 6476 10872503 154970 154970 11027473 10596247 6476 6476 10589771 154970 154970 10744741 PART X, LINE 2: THE HEALTH CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HEALTH CENTER ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE HEALTH CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2018 AND 2017, THE HEALTH CENTER HAD NO UNCERTAIN TAX POSITIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 154,970. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 154,970. X X 0 0 0 0 0 0 0 1 0 DR HORACIO ALVAREZ RAMIREZ PHYSICIAN 193302 0 2785 0 0 0 5394 0 9372 0 210853 0 0 0 DR MICHAEL ISREAL PHYSICIAN 210258 0 8234 0 48 0 6736 0 27933 0 253209 0 0 0 DR ARATHI REDDY DENTIST 165988 0 0 0 0 0 6639 0 0 0 172627 0 0 0 DR DERRICK ANDERSON PHYSICIAN 216216 0 0 0 90 0 6975 0 9190 0 232471 0 0 0 DR SARAH CASTILLO PHYSICIAN 168177 0 0 0 0 0 3953 0 101 0 172231 0 0 0 PART I, LINE 7 BLUESTEM HEALTH IS PART OF AN ORGANIZATION THAT STRIVES TO SAVE INSURANCE COMPANIES MONEY WHILE ALSO IMPROVING THE HEALTH OF PATIENTS. THE ORGANIZATION SETS OVERALL MEASURES/GOALS FOR THE HEALTH CENTER TO ACHIEVE. BASED ON HOW WELL THE HEALTH CENTER PERFORMS AND THE OUTCOMES IT PRODUCES FOR PATIENTS, THE HEALTH CENTER RECEIVES INCENTIVE PAYMENTS. THESE PAYMENTS ARE THEN PAID OUT TO THE PROVIDERS AND SUPPORT STAFF WHO HELPED THE HEALTH CENTER PERFORM AT AND ABOVE THEIR GOALS. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE COMMITTEE REVIEWS THE FORM 990 AND PRESENTS IT TO THE BOARD OF DIRECTORS WITH A RECOMMENDATION FOR APPROVAL BEFORE IT IS SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY RESPONSIBLE PERSONS AND EACH RESPONSIBLE PERSON MUST ANNUALLY COMPLETE A DISCLOSURE FORM IDENTIFYING ANY POSSIBLE CONFLICTS OF INTEREST. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND UPDATED AT THE ANNUAL MEETING EACH YEAR. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS OF BLUESTEM HEALTH SETS THE COMPENSATION FOR THE EXECUTIVE DIRECTOR AND OTHER KEY EMPLOYEES. THEY REVIEW AN ANNUAL SALARY SURVEY CONDUCTED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. THE BOARD ALSO REVIEWS THE SALARY SURVEY FOR NONPROFIT ORGANIZATIONS CONDUCTED BY THE MEDICAL GROUP MANAGEMENT ASSOCIATION. DECISIONS FOR COMPENSATION ARE BASED ON A PERSON'S EXPERIENCE, SKILLS AND EDUCATIONAL LEVEL. THE SALARIES ARE APPROVED WITH A MAJORITY VOTE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 BLUESTEM HEALTH MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL CONTRACTORS: PROGRAM SERVICE EXPENSES 993,418. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 993,418. ADMINISTRATIVE SUPPORT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 206,696. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 206,696. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS OF BLUESTEM HEALTH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.