PEOPLES COMMUNITY HEALTH CLINIC INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PEOPLES COMMUNITY HEALTH CLINIC INC (EIN 42-1058629)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-02-06
- IRS object ID
- 201520379349300122
- Schema version
- 2013v4.0
- 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 | 2015-02-06T11:31:45-06:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420991212 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOGAN - HANSEN PC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 240 | AddressLine1 |
| City | WATERLOO | City |
| State | IA | State |
| ZIP Code | 507040240 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421058629 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEOPLES COMMUNITY HEALTH CLINIC | BusinessNameLine1 |
| Business Name Line2 | INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEOP | BusinessNameControlTxt |
| Phone | 3192724300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 905 FRANKLIN STREET | AddressLine1 |
| City | WATERLOO | City |
| State | IA | State |
| ZIP Code | 50703 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNIFER LIGHTBODY | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3192724300 | PhoneNum |
| Signature | 2015-01-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | STEVEN K DUGGAN CPA | PreparerPersonNm |
| PTIN | P00424293 | PTIN |
| Phone | 3192335225 | PhoneNum |
| Preparation | 2015-01-30 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JENNIFER LIGHTBODY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 905 FRANKLIN STREET | AddressLine1 |
| City | WATERLOO | City |
| State | IA | State |
| ZIP Code | 50703 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,251,442 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PEOPLES-CLINIC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1976 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | DEDICATED TO PROVIDING ACCESS TO AFFORDABLE, COMPASSIONATE, HIGH QUALITY HEALTH CARE FOR ALL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 181 | TotalEmployeeCnt |
| Total Volunteers | 2 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,715,687 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,616,893 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,026,816 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,634,548 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2 | PYInvestmentIncomeAmt |
| CY Investment Income | $1 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $11,742,505 | PYTotalRevenueAmt |
| CY Total Revenue | $12,251,442 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,853,103 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,189,686 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,817,344 | PYOtherExpensesAmt |
| CY Other Expenses | $3,955,730 | CYOtherExpensesAmt |
| PY Total Expenses | $11,670,447 | PYTotalExpensesAmt |
| CY Total Expenses | $12,145,416 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $72,058 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $106,026 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,364,639 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,593,240 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $646,534 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $769,109 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,718,105 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,824,131 | NetAssetsOrFundBalancesEOYAmt |
| Mission | DEDICATED TO PROVIDING ACCESS TO AFFORDABLE, COMPASSIONATE, HIGH QUALITY HEALTH CARE FOR ALL. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $9,585,732 | ExpenseAmt |
| Revenue | $8,634,548 | RevenueAmt |
| Desc | PRIMARY MEDICAL HEALTH CARE AND DENTAL SERVICES PROVIDED TO THE PUBLIC. | Desc |
| Total Program Service Expenses | $9,585,732 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 14 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 181 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANNE MERSHON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3192724300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 905 FRANKLIN STREET | AddressLine1 |
| City | WATERLOO | City |
| State | IA | State |
| ZIP Code | 50703 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|
| RYAN SHERIDAN | |||||||
| CHAIRPERSON | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DEBRA HARMON | |||||||
| VICECHAIR | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SEAN GRANT | |||||||
| TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BRUCE JEFFERSON | |||||||
| SECRETARY | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TIM HORRIGAN | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| TIM HUBER | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN MUNNIK | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DERVISA SISIC | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| KRISTEN VAN VELDHUIZEN | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER LIGHTBODY | |||||||
| CEO | 40.00 | Yes (X) | $94,754 | $0 | $16,670 | ||
| CHRISTINE KEMP | |||||||
| COO | 40.00 | Yes (X) | $71,951 | $0 | $16,744 | ||
| ANNE MERSHON | |||||||
| CFO | 40.00 | Yes (X) | $63,697 | $0 | $13,824 | ||
| DR SHARON DUCLOS | |||||||
| CO-MEDICAL D | 40.00 | $168,035 | $0 | $20,028 | Yes (X) | ||
| DR KIMBERLY NEUMAN | |||||||
| CO-MEDICAL D | 40.00 | $151,074 | $0 | $28,244 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $549,511 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $95,510 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LABCORP | |||||
| 358 SOUTH MAIN STREET | BURLINGTON | NC | 27215 | LAB | $381,595 |
| MCKESSON | |||||
| ONE POST STREET | SAN FRANCISCO | CA | 94104 | PHARMACY | $323,242 |
| INCONCERT CARE | |||||
| 9943 HICKMAN RD SUITE 103 | URBANDALE | IA | 50322 | PRIMARY CARE | $322,335 |
| COMPHEALTH MEDICAL STAFFING | |||||
| 2900 CHARLEVOIX DR SE SUITE 200 | GRAND RAPIDS | MI | 49546 | MEDICAL STAFF | $183,138 |
| ALLEN MEMORIAL HOSPITAL - IOWA CARE | |||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | HOSPITAL | $113,780 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $88,233 | FederatedCampaignsAmt |
| Government Grants | $2,873,462 | GovernmentGrantsAmt |
| All Other Contributions | $655,198 | AllOtherContributionsAmt |
| Noncash Contributions | $645,422 | NoncashContributionsAmt |
| Total Contributions | $3,616,893 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| MEDICAID | $5,418,932 | $5,418,932 |
| PRIVATE INSURANCE | $1,689,009 | $1,689,009 |
| MEDICARE | $735,742 | $735,742 |
| PATIENT FEE | $698,568 | $698,568 |
| OPERATING INCOME | $92,297 | $92,297 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,634,548 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1 | TotalRevenueColumnAmt |
| Exclusion | $1 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,251,442 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,634,548 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $597,289 | TotalAmt |
| Program Services | $339,268 | ProgramServicesAmt |
| Management And General | $258,021 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,112,946 | TotalAmt |
| Program Services | $5,037,111 | ProgramServicesAmt |
| Management And General | $1,075,835 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,929 | TotalAmt |
| Program Services | $174,631 | ProgramServicesAmt |
| Management And General | $37,298 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $800,044 | TotalAmt |
| Program Services | $589,820 | ProgramServicesAmt |
| Management And General | $210,224 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $467,478 | TotalAmt |
| Program Services | $372,860 | ProgramServicesAmt |
| Management And General | $94,618 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,979 | TotalAmt |
| Program Services | $45,979 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,091 | TotalAmt |
| Management And General | $5,091 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,147 | TotalAmt |
| Program Services | $672 | ProgramServicesAmt |
| Management And General | $17,475 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,064 | TotalAmt |
| Program Services | $1,051 | ProgramServicesAmt |
| Management And General | $13 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,425 | TotalAmt |
| Program Services | $69,993 | ProgramServicesAmt |
| Management And General | $115,432 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,994 | TotalAmt |
| Program Services | $102,122 | ProgramServicesAmt |
| Management And General | $18,872 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,754 | TotalAmt |
| Program Services | $17,269 | ProgramServicesAmt |
| Management And General | $7,485 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,614 | TotalAmt |
| Program Services | $27,335 | ProgramServicesAmt |
| Management And General | $14,279 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36 | TotalAmt |
| Management And General | $36 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $305,799 | TotalAmt |
| Program Services | $221,366 | ProgramServicesAmt |
| Management And General | $84,433 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,531 | TotalAmt |
| Program Services | $15,921 | ProgramServicesAmt |
| Management And General | $18,610 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,235,765 | $1,235,765 | |
| REFERRALS/OTHER | $687,812 | $687,812 | |
| COMPUTER EXPENSE - MGMT | $460,198 | $460,198 | |
| CONTRACTED WORKER | $262,413 | $262,413 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $526,108 | TotalAmt |
| Program Services | $384,344 | ProgramServicesAmt |
| Management And General | $141,764 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,145,416 | TotalAmt |
| Program Services | $9,585,732 | ProgramServicesAmt |
| Management And General | $2,559,684 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,572 | BOYAmt |
| EOY | $3,623 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $477,103 | BOYAmt |
| EOY | $438,411 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $183,619 | BOYAmt |
| EOY | $92,936 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $543,857 | BOYAmt |
| EOY | $966,237 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,764 | BOYAmt |
| EOY | $91,750 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,501 | BOYAmt |
| EOY | $57,487 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,184,638 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,288,917 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,979,755 | BOYAmt |
| EOY | $4,895,721 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,468 | BOYAmt |
| EOY | $47,075 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,364,639 | BOYAmt |
| EOY | $6,593,240 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $646,534 | BOYAmt |
| EOY | $769,109 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $646,534 | BOYAmt |
| EOY | $769,109 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,718,105 | BOYAmt |
| EOY | $5,824,131 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,718,105 | BOYAmt |
| EOY | $5,824,131 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,364,639 | BOYAmt |
| EOY | $6,593,240 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $106,026 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | 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 | $3,814,827 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,192,957 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,903,928 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,715,687 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,616,893 | CurrentTaxYearAmt |
| Total | $19,244,292 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,814,827 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,192,957 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,903,928 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,715,687 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,616,893 | CurrentTaxYearAmt |
| Total | $19,244,292 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $19,244,292 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,117 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,272 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1 | CurrentTaxYearAmt |
| Total | $9,394 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $19,253,686 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $8,634,548 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99950 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99930 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART I-A, LINE 1 | FormAndLineReferenceDesc |
| Explanation | DUES ARE PAID TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING EXPENSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $878,318 | OtherCostOrOtherBasisAmt |
| Book Value | $878,318 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,000,928 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,225,231 | DepreciationAmt |
| Book Value | $3,775,697 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,305,392 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,063,686 | DepreciationAmt |
| Book Value | $241,706 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,895,721 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $12,251,442 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $12,251,442 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $12,251,442 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,145,416 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $12,145,416 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $12,145,416 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | MANAGEMENT ANNUALLY MAKES AN APPROPRIATE EVALUATION OF ANY UNCERTAIN INCOME TAX POSITIONS BASED UPON CURRENT STATUTES IN COMPLETING THESE FINANCIAL STATEMENTS AND THE NOTES TO THE FINANCIAL STATEMENTS. AS OF JUNE 30, 2014, MANAGEMENT BELIEVES THAT THERE WERE NO UNCERTAIN INCOME TAX POSITIONS FOR WHICH A MATERIAL CHANGE IN THE UNRECOGNIZED EFFECT WOULD BE REASONABLY POSSIBLE WITHIN THE NEXT 12 MONTHS. THE OPEN YEARS FOR AUDIT OF THE ORGANIZATION'S INCOME TAX RETURNS ARE 2011-2014. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| DR SHARON DUCLOS | ||||
| CO-MEDICAL DIRECTOR | $168,035 | $8,711 | $11,317 | $188,063 |
| DR KIMBERLY NEUMAN | ||||
| CO-MEDICAL DIRECTOR | $151,074 | $8,048 | $20,196 | $179,318 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE CEO REVIEWS COMPARATIVE SALARY INFORMATION COLLECTED THROUGH THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE IOWA/NEBRASKA PRIMARY HEALTH CARE ASSOCIATION THEN RECOMMENDS COMPENSTION FOR PHYSICIANS AND KEY EMPLOYEES THROUGH THE ANNUAL BUDGETING PROCESS. THE BOARD OF DIRECTORS ANNUALLY REVIEWS AND APPROVES THE BUDGET. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 12661 | ContributionCnt |
| Noncash Contributions Rpt F990 | $638,200 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | 340B PRICING | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | DENTAL EQUIP | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $7,222 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | DONOR ADVISED | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | PRIOR TO BEING FILED THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AND PRESENTED TO THE FULL BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY WITH DIRECTORS, OFFICERS AND KEY EMPLOYEES. WRITTEN CERTIFICATION IS REQUESTED AT THE TIME OF REVIEW. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS COMPARATIVE SALARY INFORMATION COLLECTED THROUGH THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE IOWA/NEBRASKA PRIMARY CARE ASSOCIATION THEN DETERMINES COMPENSATION FOR THE EXECUTIVE DIRECTOR. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE EXECUTIVE DIRECTOR REVIEWS COMPARATIVE SALARY INFORMATION COLLECTED THROUGH THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE IOWA/NEBRASKA PRIMARY HEALTH CARE ASSOCIATION THEN RECOMMENDS COMPENSATION FOR KEY EMPLOYEES THROUGH THE ANNUAL BUDGETING PROCESS. THE BOARD OF DIRECTORS ANNUALLY APPROVES THE BUDGET. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE CLINIC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THE ORGANIZATION'S MAIN OFFICE UPON REQUEST. |