2016-09-12T08:58:21-05:00 2016-02-29 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2015-03-01 470548990 ONEWORLD COMMUNITY HEALTH CENTERS INC ONEW 4027344110 4920 SOUTH 30TH STREET NO 103 OMAHA NE 68107 ANDREA SKOLKIN CHIEF EXECUTIVE OFFICER 4027344110 2016-09-06 1 BARBARA J FAJEN P00400874 4023302660 2015 2017-02-10 21:41:12Z ANDREA SKOLKIN 4920 SOUTH 30TH STREET NO 103 OMAHA NE 68107 37323817 0 X WWW.ONEWORLDOMAHA.ORG X 1975 NE PRIMARY CARE SERVICES TO PATIENTS INCLUDE A FACE TO FACE VISIT WITH A MEDICAL PROVIDER TO ASSESS THEIR MEDICAL NEEDS. DENTAL SERVICES INCLUDE VISITS WITH DENTISTS OR HYGIENISTS TO PROVIDE TEETH CLEANING, ORAL EXAMS AND SOME RESTORATIVE SERVICES. BEHAVIORAL SERVICES INCLUDE PATIENTS SEEN BY THE BEHAVIORAL THERAPISTS AND PSYCHIATRISTS. PHARMACY SERVICES PROVIDE PRESCRIPTION MEDICATION TO ONEWORLD'S PATIENTS. ONEWORLD ALSO PROVIDES WIC SERVICES TO LOW INCOME MOTHERS AND CHILDREN AND OTHER SUPPORTIVE SERVICES. 16 16 475 22 0 0 16349469 18194996 12914918 14343831 227687 119348 1409065 1150954 30901139 33809129 37894 63268 0 0 16909174 19272383 0 0 260373 12534270 13777885 29481338 33113536 1419801 695593 26751072 28078607 2915464 3821981 23835608 24256626 X ONEWORLD COMMUNITY HEALTH CENTERS, IN PARTNERSHIP WITH THE COMMUNITY, PROVIDE CULTURALLY RESPECTFUL, QUALITY HEALTHCARE WITH SPECIAL ATTENTION TO THE UNDERSERVED. 0 0 18770527 42073 10871631 MEDICAL CLINIC - TO PROVIDE HEALTH CARE SERVICES TO UNDERSERVED INDIVIDUALS IN OMAHA, PLATTSMOUTH AND 4 SCHOOL BASED HEALTH CLINICS. FOR THIS CURRENT YEAR, ONEWORLD PROVIDED 85,824 VISITS TO 31,771 PATIENTS. 2994509 6712 1629282 THE DENTAL CLINIC PROVIDED 16,280 VISITS TO 8,003 PATIENTS. 6461751 14483 943548 THE PHARMACY DEPARTMENT CONTINUED TO GROW RESULTING IN INCREASED PATIENT VOLUME. IN THIS CURRENT YEAR, IT PROVIDED 94,841 SCRIPTS. 2100523 2047373 OTHER PROGRAM SERVICES 2100523 2047373 30327310 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 1 41 0 1 475 1 0 0 0 0 0 1 1 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X TOM MCLAUGHLIN 4025028858 4920 SOUTH 30TH STREET 103 OMAHA NE 68107 DONOVAN HUTCHENS BOARD CHAIR 2.00 0.00 X X 0 0 0 DAVE RIDDER VICE CHAIR 2.00 0.00 X X 0 0 0 BRENT BLUME TREASURER 2.00 0.00 X X 0 0 0 PAULA SCHULZ SECRETARY 2.00 0.00 X X 0 0 0 NURIA ARCHER BOARD MEMBER 2.00 0.00 X 0 0 0 ROBERT DUNLAY MD BOARD MEMBER 2.00 0.00 X 0 0 0 JEAN FLOTT BOARD MEMBER 2.00 0.00 X 0 0 0 KRISTINA JORDAN BOARD MEMBER 2.00 0.00 X 0 0 0 ANDREW KLOECKNER BOARD MEMBER 2.00 0.00 X 0 0 0 DANIEL MCMAHON BOARD MEMBER 2.00 0.00 X 0 0 0 SHANNON WALLACE BOARD MEMBER 2.00 0.00 X 0 0 0 DIANA LISKA BOARD MEMBER 2.00 0.00 X 0 0 0 ROBERT HILKEMANN BOARD MEMBER 2.00 0.00 X 0 0 0 MARISELA RINCON BOARD MEMBER 2.00 0.00 X 0 0 0 DENNIS SNOOK BOARD MEMBER (THROUGH JUNE 2015) 2.00 0.00 X 0 0 0 TIFFANIE WRIGHT BOARD MEMBER 2.00 0.00 X 0 0 0 DUSTIN ZABOKRTSKY BOARD MEMBER 2.00 0.00 X 0 0 0 ANDREA SKOLKIN CHIEF EXECUTIVE OFFICER 40.00 0.00 X 247400 0 33470 TOM MCLAUGHLIN CHIEF FINANCIAL OFFICER 40.00 0.00 X 124974 0 20179 KRISTINE MCVEA CHIEF MEDICAL OFFICER 40.00 0.00 X 226999 0 33089 HENRY DETHLEFS IV PHYSICIAN 40.00 0.00 X 184745 0 30274 ALEX DWORAK ASSOCIATE MEDICAL DIRECTOR OF FAMILY PRACTICE 36.00 0.00 X 157682 0 28542 WESLEY MEYER PHYSICIAN 40.00 0.00 X 156090 0 12018 CHRISTINA KIM PHYSICIAN 40.00 0.00 X 152251 0 11950 1250141 0 169522 20 0 1 0 LUND ROSS PO BOX 3688 OMAHA NE 68103 CONSTRUCTION FEES 1605126 CUSTOM COMPUTING CORPORATION 11135 MILL VALLEY ROAD OMAHA NE 68154 BILLING SERVICES 475233 SELDIN COMPANY 16910 FRANCES STREET STE 200 OMAHA NE 68130 PROPERTY MANAGEMENT 392137 HEARTLAND COMMUNITY HEALTH NETWORK 4910 S 30TH STREET OMAHA NE 68107 MEDICAL SERVICES 223757 MIDWEST MAINTENANCE INC 2901 Q STREET OMAHA NE 68107 JANITORIAL SERVICES 120471 8 596900 101269 9758180 7738647 4626379 18194996 MEDICAL CLINIC 621990 10871631 10871631 DENTAL 621990 1629282 1629282 SCHOOL CLINICS 621990 599077 599077 BEHAVIORAL HEALTH PROGRAM 621990 343976 343976 899865 899865 14343831 159838 159838 18194 0 18194 18194 18194 1223625 1264115 -40490 -40490 -40490 13844 101269 29087 -15243 -15243 3165034 2221486 943548 943548 SALARY REIMBURSEMENT 900099 182115 182115 INVOLUNTARY CONVERSION 900099 22340 22340 204455 33809129 15491834 0 122299 63268 63268 426022 426022 15576022 14535528 934577 105917 505419 466438 29992 8989 1573180 1404771 147466 20943 1191740 1090986 82953 17801 47192 2252 44940 101182 101182 52363 52363 1705645 1464372 174648 66625 280333 43260 237073 1164662 1024315 131043 9304 316520 305549 7022 3949 952011 952011 79971 61741 16247 1983 190550 122322 66112 2116 863108 863108 106248 106074 174 PHARMACEUTICALS USED IN 4614636 4614636 BAD DEBT EXPENSE 2005879 2005879 MEDICAL SUPPLIES 691501 691501 LABORATORY 336890 336890 269194 172409 74039 22746 33113536 30327310 2525853 260373 1158680 1109872 4406551 4227309 1313042 1231862 1203225 1348849 663353 560468 175957 206708 489778 626365 18267986 5774991 10883153 12492995 5470054 5300418 987279 973761 26751072 28078607 2024790 2817761 694674 808220 196000 196000 2915464 3821981 X 21174249 22405532 2661359 1851094 23835608 24256626 26751072 28078607 695593 -262832 -11743 0 X X 0 1 X 1 1 1 X 12214818 21499068 14663616 16349469 18194996 82921967 12214818 21499068 14663616 16349469 18194996 82921967 500434 82421533 143479 209059 198642 222060 178032 951272 276461 245424 271568 181059 195959 1170471 85043710 60258243 0.96920 0.96550 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 60489 10000 -1572 343 68574 48217 10000 2272 60489 33386 10000 4831 48217 21804 10000 1582 33386 11607 10000 197 21804 1.00000 0.00000 0.00000 1 0 8054694 584867 7469827 5464180 1702947 3761233 4327495 3096230 1231265 421617 390947 30670 12492995 LONG TERM NOTE PAYABLE 196000 196000 X PART X, LINE 2: ONEWORLD IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ONEWORLD HAS RECEIVED A DETERMINATION LETTER THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX-EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE ONEWORLD TO MEET A COMMUNITY BENEFIT STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. ONEWORLD ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC TOPIC 740, INCOME TAXES. ONEWORLD RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT FEBRUARY 29, 2016 AND FEBRUARY 28, 2015, ONEWORLD HAD NO UNCERTAIN TAX POSITIONS ACCRUED. MILAGRO DINNER 100800 87247 13553 500 14259 8248 CINCO 2014 14313 14022 291 3993 1127 960 115113 101269 13844 4493 15386 9208 29087 -15243 1 CAB RIDES, SMALL MEDICAL SUPPLIES AND PRESCRIPTION DRUGS 1822 29188 FAIR MARKET VALUE CAB RIDES, SMALL MEDICAL SUPPLIES AND PRESCRIPTION DRUGS PART I, LINE 2: ONEWORLD DETERMINES A PATIENT'S ELIGIBILITY FOR ASSISTANCE BY OBTAINING THE PATIENT'S INCOME INFORMATION. THE FULL FREE DONATION STATUS OR THE EXEMPTION FROM THE SLIDING FEE SCALE APPLIED TO PATIENT ACCOUNTS IS TO ASSIST THOSE PATIENTS WITHOUT THE MEANS TO PAY FOR MEDICAL CARE. THE FINANCIAL STATUS OF THE PATIENT IS ASSESSED AT A MEETING WITH A FINANCIAL COUNSELOR. THE PATIENT PROVIDES DOCUMENTATION OF FINANCIAL HARDSHIP FOR DISCUSSION AT THAT MEETING. IF THE FINANCIAL COUNSELOR DETERMINES THAT IT IS NOT POSSIBLE FOR THE PATIENT TO PAY, THEN THE PATIENT MEETS WITH A SOCIAL SERVICES REPRESENTATIVE TO DETERMINE IF THE PATIENT QUALIFIES FOR FULL FREE DONATION STATUS. AS A TOOL AND TO MAINTAIN CONSISTENCY, THE SOCIAL SERVICES DEPARTMENT REPRESENTATIVE USES THE FULL FREE DONATION STATUS QUESTIONNAIRE TO MAKE THE ASSESSMENT. THE PATIENT CAN QUALIFY FOR FULL FREE DONATION STATUS FOR A PERIOD OF 1 TO 3 MONTHS. A REPORT DETAILING THE PATIENTS QUALIFYING FOR FULL FREE DONATION STATUS IS REVIEWED MONTHLY BY THE CFO AND CEO OF ONEWORLD. X X X X X 0 0 0 0 0 1 0 0 0 ANDREA SKOLKIN CHIEF EXECUTIVE OFFICER 219215 0 19300 0 8885 0 11116 0 22354 0 280870 0 0 0 KRISTINE MCVEA CHIEF MEDICAL OFFICER 216558 0 10000 0 441 0 10637 0 22452 0 260088 0 0 0 HENRY DETHLEFS IV PHYSICIAN 184498 0 0 0 247 0 8622 0 21652 0 215019 0 0 0 ALEX DWORAK ASSOCIATE MEDICAL DIRECTOR OF FAMILY 157576 0 0 0 106 0 7388 0 21154 0 186224 0 0 0 WESLEY MEYER PHYSICIAN 155979 0 0 0 111 0 7044 0 4974 0 168108 0 0 0 CHRISTINA KIM PHYSICIAN 152150 0 0 0 101 0 0 0 11950 0 164201 0 0 0 PART I, LINE 6 THE EXECUTIVE TEAM RECEIVED BONUSES IN APRIL OF 2015 FOR FISCAL YEAR ENDING FEBRUARY 28, 2015 THAT WAS CONTINGENT ON THE FOLLOWING 4 FACTORS EQUALLY: 1) IMPROVE PATIENT SATISFACTION ABOVE 94% 2) IMPROVE EMPLOYEE SATISFACTION ABOVE 70% 3) INCREASE THE NUMBER OF PATIENT VISITS BY 3-5% 4) INCREASE FUNDING SOURCES BY 3-5% THE BOARD OF DIRECTORS ELECTED/APPROVED TO ELIMINATE BONUSES FOR THE EXECUTIVE TEAM FOR YEARS BEGINNING AFTER FEBRUARY 28, 2015. X 678 4626379 FAIR MARKET VALUE 0 1 0 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTIONS IS THE NUMBER OF THE TYPES OF PHARMACEUTICALS RECEIVED. FORM 990, PART VI, SECTION B, LINE 11 BEFORE FILING FORM 990, A DRAFT IS PROVIDED TO THE CFO AND CEO FOR REVIEW. IF ANY CORRECTIONS OR CHANGES ARE NEEDED, THE CFO AND CEO COMMUNICATE THE CHANGES IN WRITING TO THE PREPARER. THE PREPARER ISSUES A REVISED DRAFT OF FORM 990 AND IT IS PROVIDED TO THE FINANCE COMMITTEE FOR DISCUSSION AND REVIEW. UPON ACCEPTANCE BY THE FINANCE COMMITTEE, THE FORM IS PRESENTED TO THE BOARD FOR THE FINAL APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH NEW EMPLOYEE AND NEW BOARD MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY. THE POLICY IS ALSO REVISITED QUARTERLY AT EACH STAFF MEETING TO REMIND EMPLOYEES TO REPORT ANY TRANSACTIONS RESULTING IN CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION STRUCTURES AT ONEWORLD ARE REVIEWED AND APPROVED ANNUALLY. AN INDEPENDENT THIRD PARTY REVIEW IS CONDUCTED EVERY THREE YEARS. THE LATEST INDEPENDENT REVIEW OCCURRED IN THE FALL OF 2014. IN YEARS WHEN AN INDEPENDENT REVIEW IS NOT CONDUCTED, THE PROCESS BEGINS WITH AN ANNUAL SALARY COMPARISON ACROSS NATIONAL, REGIONAL, AND LOCAL SALARY SURVEYS AND ONEWORLD'S SALARY RANGE STRUCTURES. IF ADJUSTMENTS ARE NEEDED FOR ANY RANGE TO REMAIN COMPETITIVE AGAINST THE MARKET, SUCH CHANGES ARE SUGGESTED AND REVIEWED FOR APPROVAL BY THE COMPENSATION COMMITTEE AND THE ENTIRE BOARD. ONEWORLD USES THE FOLLOWING PUBLISHED SALARY SURVEYS FOR COMPARISON: NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, NON-PROFIT ASSOCIATION OF THE MIDLANDS, HUMAN RESOURCE ASSOCIATION OF THE MIDLANDS, AND THE MEDICAL GROUP MANAGEMENT ASSOCIATION. ONEWORLD POSITION DESCRIPTIONS ARE COMPARED AGAINST THE SURVEY POSITION DESCRIPTIONS AND LIKE POSITION SALARIES ARE COMPARED AGAINST THE 25TH AND 75TH PERCENTILES OF SURVEY DATA. IF THERE ARE LARGE CHANGES IN THE MARKET FOR A POSITION, THIS INFORMATION IS ASSESSED AND A DETERMINATION IS MADE IF OUR RANGE IS COMPETITIVE OR SHOULD BE ADJUSTED. ONCE SURVEY ASSESSMENT IS COMPLETE, RECOMMENDATIONS ARE SENT TO THE ONEWORLD BOARD OF DIRECTORS FOR APPROVAL OF SALARY RANGES BY POSITION FOR THE YEAR. IN CONSIDERATION OF A SPECIFIC POSITION, SPECIFIC EMPLOYEE OR SPECIFIC CANDIDATE; ONEWORLD WILL TAKE INTO ACCOUNT ONE'S EXPERIENCE, EDUCATION, AND LEVEL OF RESPONSIBILITY TO DETERMINE WHERE ONE'S SALARY WOULD BE WITHIN THE APPROVED SALARY RANGE. POSITION DESCRIPTIONS ARE REVIEWED AND UPDATED EACH YEAR DURING ANNUAL REVIEWS IN THE EARLY SPRING. THE ANNUAL REVIEW OF SALARY RANGES TAKES PLACE IN THE LATE FALL/ EARLY WINTER OF EACH YEAR WITH BOARD APPROVAL BY FEBRUARY OF EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CURRENTLY, WE ARE WORKING ON A WEBSITE THAT WILL ULTIMATELY PUBLISH THIS INFORMATION FOR PUBLIC USE. FORM 990, PART XI, LINE 2C: THERE HAVE BEEN NO CHANGES FROM THE PRIOR YEAR. THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT ACCOUNTANT AND HAS THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. UPON CONCLUSION OF THE AUDIT, THE AUDITING FIRM PRESENTS THE RESULTS AND FINDINGS TO THE AUDIT COMMITTEE AND THE BOARD OF DIRECTORS. ONEWORLD COMMUNITY BUILDERS LLC 4980 S 30TH STREET SUITE 103 OMAHA NE 68107 270791687 FACILITY DEVELOPMENT NE 0 0 ONEWORLD COMMUNITY HEALTH CENTERS INC ONEWORLD EXCHANGE LLC 4980 S 30TH STREET SUITE 103 OMAHA NE 68107 463690550 FACILITY DEVELOPMENT NE 0 0 ONEWORLD COMMUNITY HEALTH CENTERS INC LIVESTOCK COMMONS LLC 4980 S 30TH STREET SUITE 103 OMAHA NE 68107 270831017 LOW INCOME HOUSING NE ONEWORLD COMMUNITY BUILDERS LLC RELATED 0 1 0.00010 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 LIVESTOCK COMMONS LLC A 30232 ACCRUED INTEREST