2015-08-24T13:39:31-05:00 2014-10-31 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2013-11-01 371270794 HEARTLAND COMMUNITY HEALTH CLINIC % CHARLES BANDOIAN HEAR 3096807600 2214 N UNIVERSITY STREET Suite PEORIA IL 61604 CHARLES BANDOIAN CEO 3006807600 2015-06-26 true Brian D Todd P00422601 3006807600 2013 2016-03-07 17:11:31Z X CHARLES BANDOIAN 2214 N UNIVERSITY STREET PEORIA IL 61604 15497435 false X WWW.HEARTLANDCHC.ORG 1990 IL THE MISSION OF HEARTLAND COMMUNITY HEALTH CLINIC IS TO PROVIDE ACCESSIBLE, HIGH QUALITY, COMPREHENSIVE PRIMARY HEALTH CARE SERVICES FOR THE MEDICALLY UNDERSERVED. 16 16 109 20 0 0 2528789 7673664 4505545 7823187 569 584 0 0 7034903 15497435 0 0 0 0 3925905 4570193 0 0 0 3465236 8347440 7391141 12917633 -356238 2579802 3419432 7259363 490591 1750720 2928841 5508643 X TO PROVIDE ACCESSIBLE, HIGH QUALITY, COMPREHENSIVE PRIMARY HEALTH CARE SERVICES FOR THE MEDICALLY UNDERSERVED, REGARDLESS OF ABILITY TO PAY, AND TO CONDUCT HIGH QUALITY PROGRAMS IN HEALTH PROFESSIONS EDUCATION THROUGH COLLABORATIVE COMMUNITY PARTNERSHIPS. false true 9179690 7351909 50,419 MEDICAL VISITS WERE PROVIDED DURING 2014. PRIMARY HEALTH CARE MEDICAL SERVICES INCLUDE: PRIMARY CARE PROVIDED BY PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, AND NURSES; IMMUNIZATIONS AND WELL-CHILD EXAMS, PERINATAL AND FAMILY PLANNING, WOMEN'S HEALTH SERVICES, OPHTHALMOLOGY, PODIATRY, NEUROLOGY, PEDIATRIC EYE AND EAR SCREENINGS, WALK IN SERVICES FOR ESTABLISHED PATIENTS, LABORATORY ON-SITE, AND ON-SITE DISPENSARY. SEE SCHEDULE O FOR MORE INFORMATION. 588444 471278 BEHAVIORAL HEALTH CARE SERVICES INCLUDE: BRIEF THERAPY COUNSELING, AND MEDICATION MANAGEMENT VISITS WITH A PSYCHIATRIST OR NURSE PRACTITIONER. DURING THE FISCAL YEAR, 3,232 WERE PROVIDED TO 693 INDIVIDUALS. 9768134 true true false true false false false false false true true false false false true false true false false false false false false false false false false false false true false false false false false false false false true false false false false false false false false true 6 0 true 109 true false false false false false false false false false false false X 16 16 false false false false false false false true true false false true true true true true true true true false IL X CHARLES BANDOIAN 3096807608 2214 N UNIVERSITY STREET PEORIA IL 61604 ANDREW RAND DIRECTOR ENDING 3/14 1.0 X PATRICIA ANDERSON DIRECTOR ENDING 1/14 1.0 X DAVID GORENZ DIRECTOR ENDING 3/14 1.0 X ANNETTE LEWIS DIRECTOR ENDING 2/14 1.0 X WAYNE CANNON DIRECTOR 1.0 X SALLY CLOYD DIRECTOR BEGINNING 12/13 1.0 X JANET GOLDSWORTHY DIRECTOR 1.0 X ROB GROVE DIRECTOR BEGINNING 4/14 1.0 X MAMIE HENDERON DIRECTOR BEGINNING 4/14 1.0 X MARIA HERRERA DIRECTOR 1.0 X ANNETTE JACKSON DIRECTOR 1.0 X JERRY KOLB TREASURER 1.0 X X ROD LORENZ MD VICE PRESIDENT 1.0 X X BRADLEY MCMILLAN PRESIDENT 1.0 X X DAN RUFFIN DIRECTOR BEGINNING 4/14 1.0 X SHARON SMITH DIRECTOR BEGINNING 4/14 1.0 X SALLY SNYDER DIRECTOR BEGINNING 4/14 1.0 X TED SPRAGG SECRETARY 1.0 X X LANCE TOSSELL DIRECTOR BEGINNING 4/14 1.0 X AL ZIEGLER DIRECTOR 1.0 X FARRELL DAVIES CEO 40.0 X 87335 5060 NANCY NEEL CFO 40.0 X 63204 3970 GREGG STONER MD CHIEF MEDICAL DIRECTOR 38.0 X 205805 0 13624 JAMES BARNETT MD PHYSICIAN 32.0 X 134171 14801 GEORGE SHOTICK MD PHYSICIAN 24.0 X 120038 4839 DAVID HOLDEN MD PHYSICIAN 24.0 X 106431 716984 0 42294 4 false true false HUMAN SERVICE CENTER PSYCHIATRIC PROVIDER 267102 SENTINEL TECHNOLOGIES NETWORK CONSULTANTS 258227 CQUEST AMERICA EHR SYSTEM HOST 441687 OSF SAINT FRANCIS MEDICAL LEASED CLINICAL STAF 2134683 POINTCORE LLC EHR HOST 803846 9 411813 3016551 4245300 960705 7673664 PATIENT SERVICE REVENUE 624100 6619981 6619981 EHR REVENUE 624100 85000 85000 PHARMACY REVENUE 446110 912128 912128 OTHER REVENUE 624100 206078 206078 7823187 584 584 0 0 0 0 0 0 0 0 0 0 15497435 7823187 584 X 0 0 0 0 378998 219429 159569 0 0 0 0 0 3492141 1876979 1615162 0 37301 20523 16778 0 383128 352013 31115 0 278625 176351 102274 0 0 0 0 0 9247 0 9247 0 103274 0 103274 0 0 0 0 0 0 0 0 0 0 0 3184841 2562469 622372 0 39995 39995 0 0 476759 361270 115489 0 1428526 1369331 59195 0 0 0 0 0 367894 279006 88888 0 30100 10935 19165 0 0 0 0 0 27629 18524 9105 0 0 0 0 0 0 0 0 0 426496 315492 111004 69542 27372 42170 MEDICAL SUPPLIES & DRUGS 1234356 1234356 BAD DEBT 857979 857979 LICENSES, DUES, SUBSCRIPTION 47987 45313 2674 RECRUITING 32948 32948 9867 797 9070 12917633 9768134 3149499 0 1009847 2437598 246512 247079 219629 661732 517577 1315170 0 0 0 0 0 0 238927 303774 53432 115491 4442408 2275071 1123024 2167337 0 0 0 0 0 0 0 0 10484 11182 3419432 7259363 427035 1707365 0 0 29362 25883 0 0 0 0 0 0 0 0 0 0 34194 17472 490591 1750720 X 2826934 5228347 101907 280296 0 0 2928841 5508643 3419432 7259363 2579802 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true false SCHEDULE C, PART II-B, LINE 1(I) THE ORGANIZATION PAYS ANNUAL DUES TO THE ILLINOIS PRIMARY HEALTH CARE ASSOCIATION. A PORTION OF THESE DUES PAID MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES. 10484 878 180 11182 9163 1321 10484 7852 1311 9163 7892 -19 21 7852 7221 689 18 7892 1.00000 true false 59442 59442 2332613 1193273 1139340 2006020 1081798 924222 44333 44333 2167337 0 LEASE EXP PAYABLE 17472 17472 14734087 273020 -776493 -503473 15237560 259875 259875 15497435 12332674 273020 273020 12059654 857979 857979 12917633 SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENT FUNDS THE ORGANIZATION HAS TRANSFERRED ASSETS TO THE COMMUNITY FOUNDATION OF CENTRAL ILLINOIS TO ESTABLISH AN ENDOWMENT, THE PROCEEDS FROM WHICH ARE TO BE USED FOR EMERGENCY PHARMACEUTICAL ASSISTANCE. THE ORGANIZATION'S BOARD OF DIRECTORS RETAIN THE DISCRETION TO REQUEST DISBURSEMENT OF THE ENTIRE FUND EVERY THREE YEARS; THEREFORE, THE INTEREST IN THESE ASSETS ARE INCLUDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS AS TEMPORARILY RESTRICTED NET ASSETS. INCOME IS DISTRIBUTED IN ACCORDANCE WITH THE AGREEMENT WITH THE FOUNDATION AND IS INCLUDED IN TEMPORARILY RESTRICTED NET ASSETS. SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12 $(857,979) BAD DEBT EXPENSE $ 81,486 NET ASSETS RELEASED FROM RESTRICTION ----------- $(776,493) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 $259,875 TEMPORARILY RESTRICTED CONTRIBUTIONS SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1 $857,979 BAD DEBT EXPENSE X X false false false false false false false false false GREGG STONER MD CHIEF MEDICAL DIRECTOR 204990 0 815 0 0 0 8408 0 5216 0 219429 0 0 0 X 8500 960705 340B PRICING false true false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTIONS THE NUMBER CONTRIBUTIONS WAS DETERMINED BY THE NUMBER OF UNITS OF MEDICAL SUPPLIES AND VACCINES RECEIVED. ORGANIZATION'S MISSION FORM 990, PART I, LINE 1 MISSION STATEMENT: THE MISSION OF HEARTLAND COMMUNITY HEALTH CLINIC IS TO PROVIDE ACCESSIBLE, HIGH QUALITY, COMPREHENSIVE PRIMARY HEALTH CARE SERVICES FOR THE MEDICALLY UNDERSERVED, REGARDLESS OF ABILITY TO PAY, THROUGH COLLABORATIVE COMMUNITY PARTNERSHIPS. VISION STATEMENT: HEARTLAND COMMUNITY HEALTH CLINIC WILL BE A COMMUNITY OF CAREGIVERS PURSUING PERFECTION IN HEALTH CARE QUALITY, OUTCOMES, SAFETY, SERVICE AND FINANCIAL INTEGRITY. SIGNIFICANT CHANGES TO PROGRAM SERVICES FORM 990, PART III, LINE3 HEARTLAND COMMUNITY HEALTH CLINIC CEASED DIRECT PROVISION OF DENTAL SERVICES IN JUNE 2013. THE ORGANIZATION NOW REFERS DENTAL NEEDS TO THE OSF DENTAL RESIDENCY PROGRAM WHICH OPERATES AT THE ARMSTRONG AND EAST BLUFF CLINIC SITES. PROGRAM SERVICE ACTIVITY #1 DESCRIPTION (CONTINUED) FORM 990, PART III, LINE 4A OVER THE PAST THREE YEARS, THE ORGANIZATION'S PAYOR MIX HAS AVERAGED AS FOLLOWS: 66% MEDICAID, 14% SELF PAY, 10% MEDICARE, 8% PRIVATE INSURANCE, AND 2% OTHER. WELLNESS AND HEALTH PROMOTION PROGRAMS INCLUDE NUTRITION AND WELL BABY VISITS. SCREENING AND DISEASE MANAGEMENT PROGRAMS ARE OFFERED FOR THE COMMUNITY HEALTH RISKS OF DIABETES, ASTHMA AND HYPERTENSION. DURING THE FISCAL YEAR, 50,419 MEDICAL VISITS WERE PROVIDED TO 17,085 INDIVIDUALS. FORM 990 REVIEW PROCESS 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 ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A DRAFT OF THE 990 WILL BE REVIEWED BY TOP MANAGEMENT, AND A FINAL DRAFT WILL BE REVIEWED AND DISCUSSED AT A MEETING OF THE FULL BOARD OF DIRECTORS. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE COMPLETED BY ALL EMPLOYEES AND BOARD MEMBERS ANNUALLY. ANY CONFLICT OF INTEREST MUST BE FULLY DISCLOSED TO THE BOARD OF DIRECTORS IN WRITING AS SOON AS PRACTICABLE AFTER THE CONFLICT BECOMES KNOWN. THE BOARD OF DIRECTORS, ACTING WITHOUT THE VOTE OF ANY DIRECTOR WHO MAY HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE MATTER AT HAND, SHALL DETERMINE THE OPTIMUM COURSE FOR ELIMINATING THE CONFLICT AND MINIMIZING ANY APPEARANCE THAT A CONFLICT OF INTEREST EXISTS. ANY DIRECTOR WHO MAY HAVE A CONFLICT SHALL NOT BE COUNTED IN THE QUORUM FOR A MEETING WHEN BOARD ACTION IS TO BE TAKEN ON THE MATTER. THESE REQUIREMENTS SHALL NOT BE CONSTRUED AS PREVENTING THE DIRECTOR FROM BRIEFLY STATING HIS/HER POSITION IN THE MATTER OR FROM ANSWERING PERTINENT QUESTIONS OF OTHER DIRECTORS. ALL ACTIONS TAKE ON MATTERS WHICH INVOLVE A CONFLICT SHALL CLEARLY REFLECT, IN THE MINUTE OF SUCH ACTION, THAT THESE REQUIREMENTS HAVE BEEN MET. ANY DIRECTOR WITH A CONFLICT WILL NOT TAKE PART IN ANY BOARD ACTION ON SUCH MATTERS AND, AT THE REQUEST OF ANOTHER DIRECTOR, WILL BE PROHIBITED FROM TAKING PART IN ANY DISCUSSION ON THE MATTER. COMPENSATION REVIEW PROCESS FORM 990, PART VI, SECTION B, LINES 15A & 15B THE ORGANIZATION RECRUITED AND SET THE SALARY FOR A NEW CEO IN 2014. AT THAT TIME, COMPARABLE SALARY DATA FOR A CEO OF A COMMUNITY HEALTH CENTER WAS OBTAINED FROM BOTH THE ILLINOIS PRIMARY HEALTH CARE ASSOCIATION AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. THE FINAL SALARY WAS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE PROCESS WAS DOCUMENTED APPROPRIATELY IN THE ORGANIZATION'S BOARD MEETING MINUTES. THE BOARD OF DIRECTORS PERFORMS AN ANNUAL EVALUATION OF THE CEO'S COMPENSATION AND MAKES RECOMMENDATIONS FOR ANY SALARY ADJUSTMENTS. A SALARY SCALE FOR ALL EMPLOYEES WAS DEVELOPED USING LOCAL DATA, ILLINOIS PRIMARY CARE ASSOCIATION SALARY SURVEY DATA, AND NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS SALARY SURVEY DATA FOR ALL RANGES ON THE SCALE. THIS SALARY SCALE WAS UPDATED AND APPROVED IN 2014 BY THE BOARD OF DIRECTORS. THE PROCESS WAS DOCUMENTED APPROPRIATELY IN THE ORGANIZATION'S BOARD MEETING MINUTES. PURSUING PERFECTION IN HEALTH CARE QUALITY, OUTCOMES, SAFETY, SERVICE AND FINANCIAL INTEGRITY. DOCUMENT DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON APPROPRIATE WRITTEN REQUEST. SUCH DOCUMENTS WILL BE MAILED OR E-MAILED TO REQUESTORS. OTHER FEES FOR SERVICES FORM 990, PART IX, LINE 11G $ 1,537,243 OSF LEASED EMPLOYEES 597,440 OSF PRECEPTOR SALARIES 584,662 LEASED STAFF 231,492 CONTRACTED SERVICES 210,136 CONSULTANTS 23,868 PAYROLL PROCESSING SERVICES ------------ $ 3,184,841