LEMARS AREA DIALYSIS SERVICES: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
LEMARS AREA DIALYSIS SERVICES (EIN 20-4980796)
Tax period
2015-07-01 to 2016-06-30
Filed
2016-10-17
IRS object ID
201602919349300725
Schema version
2015v2.1
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)
Return2016-10-17T09:57:42-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN421377056PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WILLIAMS & COMPANY PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line121 1ST AVENUE NWAddressLine1Txt
CityLE MARSCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51031ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN204980796EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LE MARS AREA DIALYSIS SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLEMABusinessNameControlTxt
Phone7125467871PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1714 LINCOLN ST NEAddressLine1Txt
CityLE MARSCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51031ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMIKE DONLINPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone7125467871PhoneNum
Signature2016-08-22SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJEFFREY S PETERS CPAPreparerPersonNm
PTINP00109480PTIN
Phone7125467801PhoneNum
Preparation2016-08-22PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMIKE DONLINPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11008 TURNBERRY AVEAddressLine1Txt
CityLE MARSCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51031ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$612,123GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2006FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURROUNDING REGION.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$28,868PYContributionsGrantsAmt
CY Contributions Grants$2,151CYContributionsGrantsAmt
PY Program Service Revenue$1,632,688PYProgramServiceRevenueAmt
CY Program Service Revenue$563,252CYProgramServiceRevenueAmt
PY Investment Income$8,333PYInvestmentIncomeAmt
CY Investment Income$46,720CYInvestmentIncomeAmt
PY Other Revenue$35PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,669,924PYTotalRevenueAmt
CY Total Revenue$612,123CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$702,874PYOtherExpensesAmt
CY Other Expenses$798,942CYOtherExpensesAmt
PY Total Expenses$702,874PYTotalExpensesAmt
CY Total Expenses$798,942CYTotalExpensesAmt
PY Revenues Less Expenses$967,050PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$186,819CYRevenuesLessExpensesAmt
Total Assets BOY$3,103,465TotalAssetsBOYAmt
Total Assets EOY$3,045,666TotalAssetsEOYAmt
Total Liabilities BOY$39,256TotalLiabilitiesBOYAmt
Total Liabilities EOY$174,328TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,064,209NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,871,338NetAssetsOrFundBalancesEOYAmt
MissionTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURROUNDING REGION.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$798,942ExpenseAmt
Revenue$563,252RevenueAmt
DescTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURROUNDING REGIONDesc
Total Program Service Expenses$798,942TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMIKE DONLINPersonNm
Phone7125463492PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1714 LINCOLN ST NEAddressLine1Txt
CityLE MARSCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51031ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
KIRK KLOHS
TREASURER1.00Yes (X)Yes (X)$0$0$0
DAVE MILLER
DIRECTOR1.00Yes (X)$0$0$0
KATHY MCCRARY
SECRETARY1.00Yes (X)Yes (X)$0$0$0
ROBERT BROCK
DIRECTOR1.00Yes (X)$0$0$0
LE ANN ARENS
CHAIRPERSON1.00Yes (X)Yes (X)$0$0$0
MIKE DONLIN
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
DR CHOW
MEDICAL DIRE1.00Yes (X)Yes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$2,151AllOtherContributionsAmt
Total Contributions$2,151TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICARE621500$238,538$238,538
WELLMARK621500$221,004$221,004
AVERA HEALTH PLAN621500$53,656$53,656
MEDICAID621500$20,784$20,784
UNITED HEALTH CARE621500$11,298$11,298

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,972TotalRevenueColumnAmt
Related Or Exempt Func Income$17,972RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$563,252TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$46,720TotalRevenueColumnAmt
Exclusion$46,720ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$612,123TotalRevenueColumnAmt
Related Or Exempt Func Income$563,252RelatedOrExemptFuncIncomeAmt
Exclusion$46,720ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$56,916TotalAmt
Program Services$56,916ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$10,244TotalAmt
Program Services$10,244ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$4,700TotalAmt
Program Services$4,700ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$149,056TotalAmt
Program Services$149,056ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$535TotalAmt
Program Services$535ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,707TotalAmt
Program Services$5,707ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$16,398TotalAmt
Program Services$16,398ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$10,385TotalAmt
Program Services$10,385ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$14TotalAmt
Program Services$14ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$78,485TotalAmt
Program Services$78,485ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,354TotalAmt
Program Services$6,354ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
CONTRACTED LABOR$310,251$310,251
REPAIRS & MAINTENANCE$72,661$72,661
REALIZED LOSS$30,759$30,759
SUPPLIES$19,202$19,202

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$27,275TotalAmt
Program Services$27,275ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$798,942TotalAmt
Program Services$798,942ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$819,003BOYAmt
EOY$335,252EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$1,489,459EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,620BOYAmt
EOY$3,620EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,725,257LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$507,922LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,289,196BOYAmt
EOY$1,217,335EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$991,646BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,103,465BOYAmt
EOY$3,045,666EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$39,256BOYAmt
EOY$174,328EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,256BOYAmt
EOY$174,328EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,041,417BOYAmt
EOY$2,848,546EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$22,792BOYAmt
EOY$22,792EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,064,209BOYAmt
EOY$2,871,338EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,103,465BOYAmt
EOY$3,045,666EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$186,819ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$6,052OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,304,086OtherCostOrOtherBasisAmt
Depreciation$180,028DepreciationAmt
Book Value$1,124,058BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$390,921OtherCostOrOtherBasisAmt
Depreciation$317,787DepreciationAmt
Book Value$73,134BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$30,250OtherCostOrOtherBasisAmt
Depreciation$10,107DepreciationAmt
Book Value$20,143BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,217,335TotalBookValueLandBuildingsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990SCHEDULE A PART I, LINE 3- LE MARS AREA DIALYSIS SERVICES DOES NOT MEET THE DEFINITION OF "HOSPITAL FACILITY" FOR PURPOSE OF THE SCHEDULE H
FORM 990, PAGE 6, PART VI, LINE 11BFORM 990 IS PROVIDED TO THE GOVERNING BODY FOR REVIEW BEFORE IT IS FILED
FORM 990, PAGE 6, PART VI, LINE 12CTHE CENTER REQUIRES BOARD MEMBERS TO DISCLOSE AND REVIEW CONFLICTS OF INTEREST ANNUALLY
FORM 990, PAGE 6, PART VI, LINE 15ATHE CLINIC MANAGER'S WAGE WAS APPROVED BY THE BOARD AFTER REVIEW OF WAGE AND SALARY DATA RECEIVED FROM FRESENIOUS MEDICAL CARE WHICH IS THE ENTITY THAT PAYS THE STAFF AT THE CENTER
FORM 990, PAGE 6, PART VI, LINE 19ALL APPROPRIATE DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC INCLUDING FORM 990 & FORM 1023 APPLICATIONS DURING NORMAL BUSINESS HOURS AT THE LE MARS AREA DIALYSIS SERVICES OFFICE AT 714 LINCOLN ST NE PO BOX 10, LE MARS, IA 51031
FORM 990, PART IX, LINE 11GMEDICAL SUPPLIES 100,468 0 0 MEDICAL WASTE EXPENSE 1,488 0 0 MEDIATION FEES 47,100 0 0
FORM 990, PART XI, LINE 9UNREALIZED LOSS -6,052 TOTAL -6,052

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