COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC (EIN 42-1527584)
- Tax period
- 2024-03-01 to 2025-02-28
- Filed
- 2025-10-17
- IRS object ID
- 202542909349300649
- Schema version
- 2024v5.2
- 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 | 2025-10-17T15:48:55-05:00 | ReturnTs |
| Tax Period End | 2025-02-28 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2021 SPRING ROAD SUITE 200 | AddressLine1Txt |
| City | OAK BROOK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-03-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421527584 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTERS OF SOUTHEASTERN | BusinessNameLine1Txt |
| Business Name Line2 | IOWA INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 3197532300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1706 W AGENCY ROAD | AddressLine1Txt |
| City | WEST BURLINGTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52655 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DIANE ROUSE | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 3197532300 | PhoneNum |
| Signature | 2025-10-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRIS MANDERFIELD | PreparerPersonNm |
| PTIN | P01238973 | PTIN |
| Phone | 6305738600 | PhoneNum |
| Preparation | 2025-10-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DIANE ROUSE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1706 W AGENCY ROAD | AddressLine1Txt |
| City | WEST BURLINGTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52655 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $32,627,191 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CHCSEIA.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | CHCSEIA PROVIDES COMPREHENSIVE HEALTH SERVICES, GENERAL DENTISTRY AND COMMUNITY HEALTH PROGRAMS, AND OTHER HEALTH CARE SERVICES TO RESIDENTS OF THE SE IOWA REGION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 238 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,735,533 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,664,700 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,902,508 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $23,476,879 | CYProgramServiceRevenueAmt |
| PY Investment Income | $169,259 | PYInvestmentIncomeAmt |
| CY Investment Income | $443,983 | CYInvestmentIncomeAmt |
| PY Other Revenue | $59,458 | PYOtherRevenueAmt |
| CY Other Revenue | $10,575 | CYOtherRevenueAmt |
| PY Total Revenue | $28,866,758 | PYTotalRevenueAmt |
| CY Total Revenue | $32,596,137 | 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 | $17,138,603 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,374,746 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,725,424 | PYOtherExpensesAmt |
| CY Other Expenses | $11,155,346 | CYOtherExpensesAmt |
| PY Total Expenses | $28,864,027 | PYTotalExpensesAmt |
| CY Total Expenses | $28,530,092 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,731 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,066,045 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $31,006,238 | TotalAssetsBOYAmt |
| Total Assets EOY | $33,518,468 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,967,938 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,372,522 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,038,300 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,145,946 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE PRIMARY HEALTH CARE TO RESIDENTS OF THE GREATER SE IOWA REGION, ESPECIALLY THOSE INDIVIDUALS/FAMILIES WITH LIMITED RESOURCES OR WITH OTHER BARRIERS TO HEALTH CARE. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,315,830 | ExpenseAmt |
| Revenue | $23,456,400 | RevenueAmt |
| Desc | COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA PROVIDES SEVERAL HEALTH SERVICES TO THE COMMUNITY, INCLUDING: COMPREHENSIVE HEALTH SERVICES WITH A VARIETY OF PHYSICIAN SPECIALTIES, GENERAL DENTISTRY AND COMMUNITY HEALTH PROGRAMS INVOLVING ORAL HEALTH EDUCATION ANDDENTAL SCREENING, FAMILY PLANNING, HEALTH SCREENINGS, IMMUNIZATIONS, CASE MANAGEMENT, AND PHARMACIES. DURING THE FISCAL YEAR, THE HEALTH CENTERS HAD 18,255 DENTAL VISITS AND 53,111 MEDICAL VISITS (INCLUDES BEHAVIORAL HEALTH). | Desc |
| Total Program Service Expenses | $18,315,830 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | 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 | 37 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 238 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | IA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIANE ROUSE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3197532300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1706 WEST AGENCY ROAD | AddressLine1Txt |
| City | WEST BURLINGTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52655 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| BARRY CORSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH DOUGLASS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHUCK GRIFFIN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVE HADEN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DELANY RICHARDS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JULIE SCHILLING | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DAVID SELMON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CINDY SHARPE | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SUZANNE SORENSEN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM STAATS | |||||||
| VICE-CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DAVID WITAKER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JEFF STRAUSE | |||||||
| CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RHEA HARTLEY | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | $358,330 | $0 | $30,117 | Yes (X) | ||
| DANIEL DUROSEAU | |||||||
| CHIEF DENTAL OFFICER | 40.00 | $278,608 | $0 | $30,921 | Yes (X) | ||
| ANTONIO FLORES TERM 81824 | |||||||
| CEO | 40.00 | $117,902 | $0 | $14,302 | Yes (X) | ||
| DIANE ROUSE | |||||||
| CFO | 40.00 | $181,001 | $0 | $39,890 | Yes (X) | ||
| WILLLIAM GRIMM | |||||||
| CEO - AS OF 11/11/24 | 40.00 | $30,335 | $0 | $2,497 | Yes (X) | ||
| ERIC BOYUM | |||||||
| PSYCHIATRIST | 40.00 | $323,455 | $0 | $46,679 | Yes (X) | ||
| MARIA DUROSEAU | |||||||
| PEDIATRICIAN | 40.00 | $292,692 | $0 | $924 | Yes (X) | ||
| RANDY ISAACS | |||||||
| PEDIATRICIAN | 40.00 | $283,416 | $0 | $26,308 | Yes (X) | ||
| SARA RODEFFER | |||||||
| DENTIST | 40.00 | $181,159 | $0 | $43,775 | Yes (X) | ||
| TESSA JOHNSON | |||||||
| DENTIST | 40.00 | $180,624 | $0 | $42,916 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,227,522 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $278,329 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 28 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ICON MEDICAL NETWORK | |||||
| 525 3RD ST SUITE 304 | LAKE OSWEGO | OR | 97034 | CONTRACTED PEDIATRIC SERVICES | $520,943 |
| PAIN CENTERS OF IOWA | |||||
| 5515 UTICA RIDGE ROAD 600 | DAVENPORT | IA | 52807 | HEALTH SERVICES | $297,015 |
| GAP RX 340B CONSULTANTS LLC | |||||
| 417 JADE DRIVE | AUGUSTA | GA | 30907 | MANAGER OF IN-HOUSE PHARMACIES | $274,129 |
| FORVIS | |||||
| PO BOX 200870 | DALLAS | TX | 75320 | AUDITORS | $135,796 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,363,637 | GovernmentGrantsAmt |
| All Other Contributions | $5,301,063 | AllOtherContributionsAmt |
| Total Contributions | $8,664,700 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 624100 | $23,148,756 | $23,148,756 |
| INCENTIVE REVENUE | 624100 | $328,123 | $328,123 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,476,879 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $475,037 | TotalRevenueColumnAmt |
| Exclusion | $475,037 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $31,054 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$31,054 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$31,054 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$31,054 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $10,575 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,575 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $10,575 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,596,137 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,456,400 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $475,037 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $966,176 | TotalAmt |
| Management And General | $966,176 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,702,031 | TotalAmt |
| Program Services | $7,957,008 | ProgramServicesAmt |
| Management And General | $4,745,023 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $548,266 | TotalAmt |
| Program Services | $305,719 | ProgramServicesAmt |
| Management And General | $242,547 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,210,671 | TotalAmt |
| Program Services | $1,025,650 | ProgramServicesAmt |
| Management And General | $1,185,021 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $947,602 | TotalAmt |
| Program Services | $552,568 | ProgramServicesAmt |
| Management And General | $395,034 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,462 | TotalAmt |
| Management And General | $60,462 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,645 | TotalAmt |
| Management And General | $151,645 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,084,785 | TotalAmt |
| Program Services | $2,721,602 | ProgramServicesAmt |
| Management And General | $363,183 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,536 | TotalAmt |
| Program Services | $68,018 | ProgramServicesAmt |
| Management And General | $221,518 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $735,481 | TotalAmt |
| Program Services | $179,365 | ProgramServicesAmt |
| Management And General | $556,116 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,302 | TotalAmt |
| Program Services | $15,999 | ProgramServicesAmt |
| Management And General | $118,303 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,284 | TotalAmt |
| Program Services | $4,204 | ProgramServicesAmt |
| Management And General | $35,080 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,582 | TotalAmt |
| Management And General | $294,582 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $955,359 | TotalAmt |
| Program Services | $374,114 | ProgramServicesAmt |
| Management And General | $581,245 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICIAL SUPPLIES AND O | Desc |
| Total | $5,409,910 | TotalAmt |
| Program Services | $5,111,583 | ProgramServicesAmt |
| Management And General | $298,327 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,530,092 | TotalAmt |
| Program Services | $18,315,830 | ProgramServicesAmt |
| Management And General | $10,214,262 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $447,872 | BOYAmt |
| EOY | $3,307,880 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,584,069 | BOYAmt |
| EOY | $8,497,145 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $440,344 | BOYAmt |
| EOY | $5,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,847,255 | BOYAmt |
| EOY | $1,982,827 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $219,881 | BOYAmt |
| EOY | $190,266 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $690,143 | BOYAmt |
| EOY | $444,440 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $21,551,855 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,962,576 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,769,265 | BOYAmt |
| EOY | $15,589,279 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $745,973 | BOYAmt |
| EOY | $787,574 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $447,828 | BOYAmt |
| EOY | $382,292 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,813,608 | BOYAmt |
| EOY | $2,331,765 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,006,238 | BOYAmt |
| EOY | $33,518,468 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,874,114 | BOYAmt |
| EOY | $2,146,151 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,676,974 | BOYAmt |
| EOY | $3,953,975 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $416,850 | BOYAmt |
| EOY | $272,396 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,967,938 | BOYAmt |
| EOY | $6,372,522 | 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 | $22,030,800 | BOYAmt |
| EOY | $27,140,946 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,007,500 | BOYAmt |
| EOY | $5,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,038,300 | BOYAmt |
| EOY | $27,145,946 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,006,238 | BOYAmt |
| EOY | $33,518,468 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,066,045 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $41,601 | NetUnrlzdGainsLossesInvstAmt |
| 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 | $5,415,566 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,481,022 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,224,635 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,735,533 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,664,700 | CurrentTaxYearAmt |
| Total | $29,521,456 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,415,566 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,481,022 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,224,635 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,735,533 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,664,700 | CurrentTaxYearAmt |
| Total | $29,521,456 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $29,521,456 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $61,533 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $101,380 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $202,056 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $169,259 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $475,037 | CurrentTaxYearAmt |
| Total | $1,009,265 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $10,575 | CurrentTaxYearAmt |
| Total | $10,575 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $30,541,296 | TotalSupportAmt |
| Public Support CY170 | 0.96660 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97720 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISC - 2024 AMOUNT: $ 10,575. | ExplanationTxt |
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 |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
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 NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC), THE IOWA PRIMARY CARE ASSOCIATION (IAPCA), AND THE ILLINOIS PRIMARY HEALTHCARE ASSOCIATION (ILPHCA). A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $306,280 | OtherCostOrOtherBasisAmt |
| Book Value | $306,280 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,487,789 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,706,374 | DepreciationAmt |
| Book Value | $14,781,415 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $58,759 | OtherCostOrOtherBasisAmt |
| Depreciation | $58,759 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,699,027 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,197,443 | DepreciationAmt |
| Book Value | $501,584 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,589,279 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM THIRD PARTY PAYERS | $2,319,394 |
| ROU ASSETS | $12,371 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,331,765 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMP | $260,026 |
| CURRENT PORTION OF OPEARTING LEASE | $4,217 |
| CURRENT PORTION OF FINANCING LEASE | $8,153 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $272,396 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $32,637,738 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $41,601 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $41,601 | RevenueNotReportedAmt |
| Revenue Subtotal | $32,596,137 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $32,596,137 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $28,530,092 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $28,530,092 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $28,530,092 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS TAX-EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND NOT A PRIVATE FOUNDATION AS DESCRIBED IN SECTION 509(A) FOR FEDERAL PURPOSES. THE ORGANIZATION IS ALSO TAX-EXEMPT UNDER IOWA STATUTES FOR STATE PURPOSES. CONSEQUENTLY, THE ORGANIZATION RECORDS NO PROVISION FOR INCOME TAXES. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. AS A RESULT OF THE APPLICATION OF THE STANDARD, THE ORGANIZATION HAS RECOGNIZED NO LIABILITY FOR UNRECOGNIZED TAX BENFITS. THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RHEA HARTLEY | ||||||||||||||
| CHIEF MEDICAL OFFICER | $315,530 | $0 | $33,670 | $0 | $9,130 | $0 | $18,038 | $0 | $12,079 | $0 | $388,447 | $0 | $0 | $0 |
| ERIC BOYUM | ||||||||||||||
| PSYCHIATRIST | $313,205 | $0 | $10,250 | $0 | $0 | $0 | $16,624 | $0 | $30,055 | $0 | $370,134 | $0 | $0 | $0 |
| RANDY ISAACS | ||||||||||||||
| PEDIATRICIAN | $283,416 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $26,308 | $0 | $309,724 | $0 | $0 | $0 |
| DANIEL DUROSEAU | ||||||||||||||
| CHIEF DENTAL OFFICER | $268,608 | $0 | $10,000 | $0 | $0 | $0 | $520 | $0 | $30,401 | $0 | $309,529 | $0 | $0 | $0 |
| MARIA DUROSEAU | ||||||||||||||
| PEDIATRICIAN | $292,692 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $924 | $0 | $293,616 | $0 | $0 | $0 |
| SARA RODEFFER | ||||||||||||||
| DENTIST | $169,739 | $0 | $11,420 | $0 | $0 | $0 | $9,737 | $0 | $34,038 | $0 | $224,934 | $0 | $0 | $0 |
| TESSA JOHNSON | ||||||||||||||
| DENTIST | $178,124 | $0 | $2,500 | $0 | $0 | $0 | $9,635 | $0 | $33,281 | $0 | $223,540 | $0 | $0 | $0 |
| DIANE ROUSE | ||||||||||||||
| CFO | $155,145 | $0 | $10,000 | $0 | $15,856 | $0 | $9,492 | $0 | $30,398 | $0 | $220,891 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1B | THE ORGANIZATION OFFERS A WELLNESS PROGRAM TO ITS EMPLOYEES WHICH PROVIDES DIRECT REIMBURSEMENT OF UP TO $25 PER MONTH TOWARDS DOCUMENTED PARTICIPATION IN AN APPROVED HEALTH ACTIVITY. EMPLOYEES MUST SUBMIT PROOF OF PAYMENT FOR THE EMPLOYEE'S MEMBERSHIP FOR THE MONTH ALONG WITH PROOF OF ATTENDANCE OF AT LEAST THREE TIMES PER MONTH |
| PART I, LINE 7 | BONUS AMOUNTS PAID ARE BASED ON PRODUCTION LEVELS AND QUALITY MEASURES. |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $488,424 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE CONSISTS OF THE 4 OFFICERS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL HAVE ALL OF THE POWERS OF THE GOVERNING BOARD WHEN THE GOVERNING BOARD IS NOT IN SESSION AND SHALL GENERALLY PERFORM SUCH DUTIES AND EXERCISE SUCH POWERS AS MAY BE DELEGATED BY THE GOVERNING BOARD. SUCH ACTIONS SHALL BE REPORTED TO AND APPROVED BY THE GOVERNING BOARD AT THE NEXT REGULARLY SCHEDULED BOARD MEETING. IT IS THE DUTY OF THE EXECUTIVE COMMITTEE TO ANNUALLY EVALUATE THE PERFORMANCE OF THE CHIEF EXECUTIVE OFFICER AND REPORT TO THE FULL 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 FINANCE DEPARTMENT OF THE ORGANIZATION. PRIOR TO BEING FILED, THE RETURN IS REVIEWED BY THE ORGANIZATION'S CFO. IT IS THEN PROVIDED TO THE BOARD FOR REVIEW AND APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | A. GENERAL PRINCIPLES PROHIBITING CONFLICTS: NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR MEMBER OF THE BOARD OF DIRECTORS OF CHC/SEIA WILL PARTICIPATE IN THE SELECTION, AWARD, OR ADMINISTRATION OF A CONTRACT OR GRANT (SUPPORTED BY FEDERAL FUNDS) IF A REAL OR APPARENT CONFLICT OF INTEREST WOULD BE INVOLVED. SUCH A CONFLICT WOULD ARISE WHEN THE EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR BOARD MEMBER, OR ANY MEMBER OF HIS OR HER IMMEDIATE FAMILY, HIS OR HER PARTNER OR AN ORGANIZATION WHICH EMPLOYS OR IS ABOUT TO EMPLOY ANY OF THE PARTIES INDICATED HEREIN, HAS A FINANCIAL OR OTHER INTEREST IN THE FIRM SELECTED FOR THE CONTRACT OR AWARD. B. CONFLICTS OF INTEREST AND DISCLOSURE REQUIREMENTS: NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR BOARD MEMBER WILL HAVE A DIRECT OR INDIRECT FINANCIAL INTEREST IN OR RECEIVE ANY COMPENSATION OR OTHER BENEFITS AS A RESULT OF TRANSACTIONS BETWEEN CHC/SEIA AND ANY INDIVIDUAL OR BUSINESS FIRM WITHOUT DISCLOSING THE CONFLICT OF INTEREST. NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER, OR MEMBER OF THE BOARD OF DIRECTORS MAY PARTICIPATE IN THE SELECTION, AWARD, OR ADMINISTRATION OF A CONTRACT OR GRANT IN WHICH FEDERAL FUNDS ARE USED, IF THEY HAVE A FINANCIAL OR OTHER INTEREST IN THE FIRM SELECTED FOR THE CONTRACT OR AWARD WITHOUT DISCLOSING THE CONFLICT OF INTEREST. IF AN EMPLOYEE, CONTRACTOR, AGENT, OFFICER, OR MEMBER OF THE BOARD OF DIRECTORS BELIEVES THAT ONE OF THE AFOREMENTIONED CONFLICTS ACTUALLY OR POTENTIALLY EXISTS, HE OR SHE MUST IMMEDIATELY DISCLOSE THIS INFORMATION IN WRITING TO THE CEO. DISCLOSURES BY MEMBERS OF THE BOARD OF DIRECTORS MUST ALSO BE MADE TO THE CHAIR OF THE BOARD OF DIRECTORS (AND IF IT IS THE CEO OR THE CHAIR WHO HAS SUCH A FINANCIAL INTEREST HE OR SHE MUST MAKE DIRECTORS (AND IF IT IS THE CEO OR THE CHAIR WHO HAS SUCH A FINANCIAL INTEREST, HE OR SHE MUST MAKE DISCLOSURE TO THE CHAIR OR VICE CHAIR, RESPECTIVELY). CHC/SEIA REQUIRES THAT ALL EMPLOYEES,CONTRACTORS, AGENTS, OFFICERS AND MEMBERS OF THE BOARD OF DIRECTORS AND CANDIDATES FOR BOARD MEMBERSHIP DISCLOSE IN WRITING (AND UPDATE AT LEAST ANNUALLY) AT OR AROUND THEIR JANUARY MEETING: - ALL BUSINESS AND FAMILY RELATIONSHIPS WHICH CREATE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, AND - WHERE APPLICABLE, PROVIDE A STATEMENT SUGGESTING HOW SUCH CONFLICT COULD BE AVOIDED OR MITIGATED. TO FACILITATE DISCLOSURE, CHC/SEIA REQUIRES EMPLOYEES, CONTRACTORS, AGENTS, OFFICERS AND BOARD MEMBERS TO COMPLETE A CHC/SEIA CONFLICT OF INTEREST FORM. COMPLETION OF THE FORM DOES NOT RELIEVE INDIVIDUALS OF THE OBLIGATION TO NOTIFY THE CEO OR BOARD CHAIR IF CHANGES OCCUR SINCE FILING OF THE FORM REGARDING A NEW CONFLICT OF INTEREST. NO MEMBER OF THE BOARD OF DIRECTORS MAY VOTE ON ANY MATTER WHICH MAY DIRECTLY OR INDIRECTLY RESULT IN FINANCIAL OR OTHER GAIN TO THAT MEMBER, OR WHICH MAY CONFLICT WITH THAT MEMBER'S OBLIGATIONS TO ANOTHER ORGANIZATION'S BOARD OF DIRECTORS OR TO HIS OR HER EMPLOYER. PROVIDED THAT THE MEMBER OF THE BOARD OF DIRECTORS HAS FIRST DISCLOSED A CONFLICT OR POTENTIAL CONFLICT, AND ABSTAINS FROM VOTING IN THAT REGARD, HE OR SHE MAY PARTICIPATE IN DISCUSSIONS RELATING TO THAT MATTER. |
| FORM 990, PART VI, SECTION B, LINE 15 | ANNUALLY, PAY RANGES ARE REVIEWED AS PART OF THE BUDGETING PROCESS. COMPARABILITY DATA IS USED FROM FQHC SALARY SURVEY RESULTS FROM NACHC, IOWA PRIMARY CARE ASSOCIATION AND ILLINOIS PRIMARY CARE ASSOCIATION. IOWA WORKFORCE DEVELOPMENT SURVEY RESULTS FOR THE REGION ARE ALSO COMPARED. ANY PROPOSED CHANGES ARE TAKEN TO CHCSEIA'S PERSONNEL COMMITTEE, FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC EXCEPT IN CASES WHERE IT IS REQUIRED BY LAW. FINANCIAL STATEMENTS ARE ONLY RELEASED FOR ACTIVITIES THAT ARE DEEMED NECESSARY FOR BONA FIDE BUSINESS PURPOSES, SUCH AS LOANS, OR IN CASES WHERE IT IS REQUIRED BY LAW. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES AND PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,721,602. MANAGEMENT AND GENERAL EXPENSES 363,183. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,084,785. |
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