SIOUXLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- SIOUXLAND COMMUNITY HEALTH CENTER (EIN 42-1374894)
- Tax period
- 2014-02-01 to 2015-01-31
- Filed
- 2015-12-07
- IRS object ID
- 201523419349300112
- Schema version
- 2014v5.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule K
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-12-07T10:12:25-06:00 | ReturnTs |
| Tax Period End | 2015-01-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-02-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421374894 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIOUXLAND COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JAN ANDERSON | InCareOfNm |
| Business Name Control | SIOU | BusinessNameControlTxt |
| Phone | 7122522477 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 NEBRASKA STREET | AddressLine1Txt |
| City | SIOUX CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51105 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARI KAPTAIN-DAHLEN | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 7122522477 | PhoneNum |
| Signature | 2015-11-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARI KAPTAIN-DAHLEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 NEBRASKA STREET | AddressLine1Txt |
| City | SIOUX CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $22,406,728 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SLANDCHC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | TO BE A PATIENT-CENTERED MEDICAL HOME THAT IMPROVES THE PHYSICAL, DENTAL, AND BEHAVIORAL HEALTH OF THE SIOUXLAND COMMUNITY WHILE ELIMINATING ACCESS BARRIERS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 264 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,693,098 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,424,315 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,962,776 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,974,012 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,583 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,768 | CYInvestmentIncomeAmt |
| PY Other Revenue | $752 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $19,664,209 | PYTotalRevenueAmt |
| CY Total Revenue | $22,404,095 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $66,750 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $128,562 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,530,743 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,008,266 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,755,760 | PYOtherExpensesAmt |
| CY Other Expenses | $7,040,679 | CYOtherExpensesAmt |
| PY Total Expenses | $20,353,253 | PYTotalExpensesAmt |
| CY Total Expenses | $20,177,507 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$689,044 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,226,588 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,608,595 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,432,084 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,091,277 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,800,732 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,517,318 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,631,352 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE SERVE OUR COMMUNITY TO BRING HEALING THROUGH OUR COMMITMENT TO CARE. | MissionDesc |
| Significant New Program Srvc | Yes (true) | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,772,661 | ExpenseAmt |
| Revenue | $11,699,284 | RevenueAmt |
| Desc | PRIMARY AND SPECIALTY MEDICAL SERVICES FOR FY 2014, SCHC PROVIDED MEDICAL, PRENATAL, AND BEHAVIORAL HEALTH SERVICES TO 25,334 PATIENTS. SERVICES WERE PROVIDED BY EIGHT PRIMARY CARE PHYSICIANS, SEVEN PHYSICIAN ASSISTANTS, EIGHT NURSE PRACTITIONERS, AND A VARIETY OF VOLUNTEER SPECIALTY PROVIDERS FROM THE SIOUXLAND COMMUNITY. SPECIALTY CARE VOLUNTEERS PROVIDED THE FOLLOWING CARE: CARDIOVASCULAR, SURGERY, PODIATRY, OPTOMETRY & NEPHROLOGY. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,032,035 | ExpenseAmt |
| Revenue | $3,292,839 | RevenueAmt |
| Desc | PHARMACY THE SCHC PHARMACY IS AVAILABLE TO ALL PATIENTS RECEIVING HEALTH CARE SERVICES AT THE HEALTH CENTER. THREE PHARMACISTS ARE ON STAFF TO OFFER MEDICATION COUNSELING FOR PRESCRIPTIONS. IN ADDITION, THE HEALTH CENTER EMPLOYED ONE FULL-TIME CLINICAL PHARMACIST TO ASSIST PATIENTS WITH CHRONIC MEDICAL CONDITIONS. SCHC IS A PARTICIPANT IN THE 340B DRUG PRICING PROGRAM AND ALSO OFFERS AN INDIGENT PROGRAM TO PROVIDE PRESCRIPTION ASSISTANCE TO QUALIFYING PATIENTS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,745,713 | ExpenseAmt |
| Revenue | $2,981,889 | RevenueAmt |
| Desc | DENTAL CARE SCHC EMPLOYED FOUR AND ONE-HALF DENTISTS AND THREE DENTAL HYGIENISTS IN FY 2014 TO PROVIDE ROUTINE DENTAL CARE AND TREATMENT TO PATIENTS AGES INFANTS TO ADULTS. EMERGENCY WALK-IN PATIENTS ARE ACCEPTED DAILY. PRENATAL ORAL HEALTH EDUCATION IS PROVIDED DURING BABY DAY APPOINTMENTS. THE DENTAL DEPARTMENT SERVED 9,301 PATIENTS DURING THE YEAR ENDING 1/31/15. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $16,550,409 | 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 | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | 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 | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | 31 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 264 | 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | 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 | false | 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 | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAN ANDERSON | PersonNm |
| Phone | 7122522477 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 NEBRASKA STREET | AddressLine1Txt |
| City | SIOUX CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51105 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JENNIFER GOMEZ | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| BIBI JAURON | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JOAN KELLY | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| NANCY METCALF | |||||||||
| PRESIDENT | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| OMAR SUAREZ | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| KELLEY MCCARTHY | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DAVID OLSON | |||||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CHAD MARKHAM | |||||||||
| VICE PRESIDENT | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| PERLA ALACORN-FLORY | |||||||||
| SECRETARY ENDING 5/14 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ANDREA BUCKLEY | |||||||||
| DIRECTOR/SECRETARY BEG 5/14 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| DONA PRINCE | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| GEORGE MCGARY | |||||||||
| DIRECTOR ENDING 10/14 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JAY ROSENBERG | |||||||||
| DIRECTOR BEGINNING 11/14 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| FRANK LAMERE | |||||||||
| DIRECTOR BEGINNING 12/14 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JACOB HARLAN | |||||||||
| DIRECTOR BEGINNING 12/14 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JOHNNY TUREAUD | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MARI KAPTAIN-DAHLEN | |||||||||
| CEO | 40.0 | 0.0 | $150,743 | $0 | $7,088 | Yes (X) | |||
| JAN ANDERSON CPA MBA | |||||||||
| CFO | 40.0 | 0.0 | $138,447 | $0 | $22,819 | Yes (X) | |||
| MICHAEL PIPLANI MD | |||||||||
| CMO | 40.0 | 0.0 | $239,898 | $0 | $16,761 | Yes (X) | |||
| JOSHUA SALANDER | |||||||||
| COO ENDING 5/14 | 40.0 | 0.0 | $46,632 | $0 | $11,501 | Yes (X) | |||
| DAVID FALDMO PA | |||||||||
| QUALITY DIRECTOR | 40.0 | 0.0 | $219,611 | $0 | $34,438 | Yes (X) | |||
| THOR SWANSON MD | |||||||||
| HIV MEDICAL DIRECTOR | 40.0 | 0.0 | $227,839 | $0 | $34,860 | Yes (X) | |||
| BRENDA HAUSMAN-MILLER MD | |||||||||
| CO-DENTAL DIRECTOR | 40.0 | 0.0 | $183,255 | $0 | $34,809 | Yes (X) | |||
| RYAN BALLER DDS | |||||||||
| CO-DENTAL DIRECTOR | 40.0 | 0.0 | $174,370 | $0 | $31,170 | Yes (X) | |||
| KRISTI WALZ MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $237,918 | $0 | $33,621 | Yes (X) | |||
| GARY HATTAN MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $231,584 | $0 | $34,312 | Yes (X) | |||
| STEPHEN PALLONE MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $197,918 | $0 | $35,621 | Yes (X) | |||
| DANIELLE ROSENKRANS MD | |||||||||
| PHYSICIAN | 32.0 | 0.0 | $172,587 | $0 | $24,386 | Yes (X) | |||
| JULIA HEATON MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $172,049 | $0 | $23,206 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,392,851 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $344,592 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 25 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| ServicesServicesDesc | CompensationCompensationAmt |
|---|---|
| INCONCERT CARE INC | |
| COMPUTER SERVICES | $440,008 |
| BKD LLP | |
| AUDIT/TAX/CONSULTING | $115,235 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $2,500 | FederatedCampaignsAmt |
| Government Grants | $3,951,335 | GovernmentGrantsAmt |
| All Other Contributions | $470,480 | AllOtherContributionsAmt |
| Noncash Contributions | $696,685 | NoncashContributionsAmt |
| Total Contributions | $4,424,315 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | $17,623,291 | $17,623,291 |
| OTHER REVENUE | 624100 | $99,971 | $99,971 |
| EHR INCENTIVE REVENUE | 624100 | $250,750 | $250,750 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,974,012 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,401 | TotalRevenueColumnAmt |
| Exclusion | $8,401 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,633 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$2,633 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,633 | TotalRevenueColumnAmt |
| Exclusion | -$2,633 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,404,095 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,974,012 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $5,768 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,562 | TotalAmt |
| Program Services | $128,562 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,577,085 | TotalAmt |
| Program Services | $1,210,511 | ProgramServicesAmt |
| Management And General | $366,574 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,354,002 | TotalAmt |
| Program Services | $7,777,624 | ProgramServicesAmt |
| Management And General | $1,576,378 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $341,970 | TotalAmt |
| Program Services | $284,057 | ProgramServicesAmt |
| Management And General | $57,913 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $989,280 | TotalAmt |
| Program Services | $813,313 | ProgramServicesAmt |
| Management And General | $175,967 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $745,929 | TotalAmt |
| Program Services | $613,668 | ProgramServicesAmt |
| Management And General | $132,261 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,770 | TotalAmt |
| Management And General | $38,770 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,442 | TotalAmt |
| Management And General | $113,442 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,107,629 | TotalAmt |
| Program Services | $930,812 | ProgramServicesAmt |
| Management And General | $176,817 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,694 | TotalAmt |
| Program Services | $3,543 | ProgramServicesAmt |
| Management And General | $35,151 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $415,463 | TotalAmt |
| Program Services | $201,917 | ProgramServicesAmt |
| Management And General | $213,546 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,058 | TotalAmt |
| Program Services | $33,804 | ProgramServicesAmt |
| Management And General | $20,254 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,258 | TotalAmt |
| Program Services | $197,618 | ProgramServicesAmt |
| Management And General | $63,640 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,863 | TotalAmt |
| Program Services | $20,482 | ProgramServicesAmt |
| Management And General | $20,381 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,395 | TotalAmt |
| Program Services | $88,204 | ProgramServicesAmt |
| Management And General | $106,191 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $285,794 | TotalAmt |
| Management And General | $285,794 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $807,308 | TotalAmt |
| Program Services | $647,194 | ProgramServicesAmt |
| Management And General | $160,114 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,705 | TotalAmt |
| Program Services | $28,624 | ProgramServicesAmt |
| Management And General | $7,081 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $2,621,025 | $2,621,025 | |
| BAD DEBT | $929,288 | $929,288 | |
| LICENSES, DUES, SUBSCRIPTION | $75,677 | $20,163 | $55,514 |
| RECRUITING & RETENTION | $11,773 | $11,773 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,537 | TotalAmt |
| Management And General | $9,537 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,177,507 | TotalAmt |
| Program Services | $16,550,409 | ProgramServicesAmt |
| Management And General | $3,627,098 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,131 | BOYAmt |
| EOY | $294,700 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,248,005 | BOYAmt |
| EOY | $2,864,429 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $522,183 | BOYAmt |
| EOY | $723,220 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,221,770 | BOYAmt |
| EOY | $1,341,317 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $304,771 | BOYAmt |
| EOY | $213,536 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,875 | BOYAmt |
| EOY | $132,663 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,350,116 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,488,897 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,905,860 | BOYAmt |
| EOY | $11,861,219 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,000 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,000 | BOYAmt |
| EOY | $1,000,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,608,595 | BOYAmt |
| EOY | $18,432,084 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,341,285 | BOYAmt |
| EOY | $1,312,292 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $56,317 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,719,168 | BOYAmt |
| EOY | $5,422,384 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,332 | BOYAmt |
| EOY | $23,693 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $873,492 | BOYAmt |
| EOY | $986,046 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,091,277 | BOYAmt |
| EOY | $7,800,732 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,273,680 | BOYAmt |
| EOY | $10,490,281 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,638 | BOYAmt |
| EOY | $141,071 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,517,318 | BOYAmt |
| EOY | $10,631,352 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,608,595 | BOYAmt |
| EOY | $18,432,084 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,226,588 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$112,554 | NetUnrlzdGainsLossesInvstAmt |
| 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 | $5,189,538 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,775,866 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,264,888 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,693,098 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,424,315 | CurrentTaxYearAmt |
| Total | $25,347,705 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,189,538 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,775,866 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,264,888 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,693,098 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,424,315 | CurrentTaxYearAmt |
| Total | $25,347,705 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $2,872,241 | SubstantialContributorsTotAmt |
| Public Support Total170 | $22,475,464 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,307 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,939 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,620 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,583 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,401 | CurrentTaxYearAmt |
| Total | $33,850 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $25,381,555 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $68,884,031 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.88550 | PublicSupportCY170Pct |
| Public Support PY170 | 0.87320 | 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| 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 | Yes (true) | OtherActivitiesInd |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1(I) | FormAndLineReferenceDesc |
| Explanation | OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAID DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE IOWA PRIMARY CARE ASSOCIATION. A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,197,727 | OtherCostOrOtherBasisAmt |
| Book Value | $1,197,727 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,187,357 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,721,189 | DepreciationAmt |
| Book Value | $9,466,168 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,964,835 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,767,708 | DepreciationAmt |
| Book Value | $1,197,127 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $197 | OtherCostOrOtherBasisAmt |
| Book Value | $197 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,861,219 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EST AMOUNT DUE FROM 3RD PARTY | Desc |
| Book Value | $1,000,000 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,000,000 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTEREST RATE SWAP | Desc |
| Amt | $986,046 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $986,046 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $21,486,070 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$112,554 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $18,617 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$303,655 | OtherRevenueAmt |
| Revenue Not Reported | -$397,592 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,883,662 | RevenueSubtotalAmt |
| Other Revenues Not Included | $520,433 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $520,433 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $22,404,095 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $19,269,469 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $18,617 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $2,633 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $21,250 | ExpensesNotReportedAmt |
| Expenses Subtotal | $19,248,219 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $929,288 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $929,288 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,177,507 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X, LINE 2 | UNCERTAIN TAX POSITIONS: 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: $ (929,288) BAD DEBT EXPENSE 625,633 NET ASSETS RELEASED FROM RESTRICTION ----------- $ (303,655) |
| SCHEDULE D, PART XI, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 523,066 TEMPORARILY RESTRICTED CONTRIBUTIONS (2,633) LOSS ON DISPOSAL OF ASSETS ---------- $ 520,433 |
| SCHEDULE D, PART XII, LINE 2D | AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 2,633 LOSS ON DISPOSAL OF ASSET |
| SCHEDULE D, PART XII, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 929,288 BAD DEBT EXPENSE |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| NEBRASKA AIDS | |||||||
| 250 S 77TH ST STE A | OMAHA | NE | 68114 | 470786622 | 501(C)(3) | $118,113 | HIV CASE MANAGE |
| COOPORTUNITY HEALTH | |||||||
| 2700 WESTOWN PKW | DES MOINES | IA | 50266 | 453468530 | 501(C)(3) | $10,429 | HIV CASE MANAGE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | MONITORING OF GRANT FUNDS: NEBRASKA AIDS PROJECT CONTINUED TO BE A SUBCONTRACTED AGENCY IN ORDER TO PROVIDE CONTRACTUAL HIV/AIDS SERVICES IN SOUTHWEST IA. THEY WERE CHOSEN ON THE BASIS OF PRIOR EXPERIENCE WITH WORKING WITH TARGETED POPULATION, AND STAFF CREDENTIALS/EXPERIENCE. THE AGENCY SUBMITS MONTHLY FINANCIAL REPORTS WITH EXPENSE DOCUMENTATION AND TIME TRACKING IN ORDER TO BE REIMBURSED. THEY ALSO SUBMIT THEIR ANNUAL AUDIT FOR REVIEW AND AN ON-SITE MONITORING REVIEW IS PERFORMED ANNUALLY. COOPORTUNITY HEALTH WAS PAID FOR PATIENT HEALTH INSURANCE PREMIUMS DURING THE YEAR IN ACCORDANCE WITH HIV GRANT FUNDING RECEIVED FROM THE STATE OF IOWA. HIV PATIENT CARE STAFF CONFIRM PATIENT ELIGIBILITY FOR PREMIUM PAYMENTS BASED ON PATIENT HEALTH STATUS AND PHYSICAL ADDRESS, AND MONITOR THE AVAILABILITY OF SUCH FUNDS MONTHLY THROUGH BUDGETARY REPORTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARI KAPTAIN-DAHLEN | ||||||||||||||
| CEO | $150,743 | $0 | $0 | $0 | $0 | $0 | $5,756 | $0 | $1,332 | $0 | $157,831 | $0 | $0 | $0 |
| KRISTI WALZ MD | ||||||||||||||
| PHYSICIAN | $215,250 | $0 | $18,300 | $0 | $4,368 | $0 | $11,938 | $0 | $21,683 | $0 | $271,539 | $0 | $0 | $0 |
| GARY HATTAN MD | ||||||||||||||
| PHYSICIAN | $230,335 | $0 | $100 | $0 | $1,149 | $0 | $11,669 | $0 | $22,643 | $0 | $265,896 | $0 | $0 | $0 |
| STEPHEN PALLONE MD | ||||||||||||||
| PHYSICIAN | $196,267 | $0 | $1,300 | $0 | $351 | $0 | $10,128 | $0 | $25,493 | $0 | $233,539 | $0 | $0 | $0 |
| DAVID FALDMO PA | ||||||||||||||
| QUALITY DIRECTOR | $189,896 | $0 | $26,749 | $0 | $2,966 | $0 | $11,130 | $0 | $23,308 | $0 | $254,049 | $0 | $0 | $0 |
| JAN ANDERSON CPA MBA | ||||||||||||||
| CFO | $137,652 | $0 | $0 | $0 | $795 | $0 | $7,045 | $0 | $15,774 | $0 | $161,266 | $0 | $0 | $0 |
| THOR SWANSON MD | ||||||||||||||
| HIV MEDICAL DIRECTOR | $227,411 | $0 | $0 | $0 | $428 | $0 | $11,517 | $0 | $23,343 | $0 | $262,699 | $0 | $0 | $0 |
| MICHAEL PIPLANI MD | ||||||||||||||
| CMO | $229,509 | $0 | $10,000 | $0 | $389 | $0 | $8,323 | $0 | $8,438 | $0 | $256,659 | $0 | $0 | $0 |
| BRENDA HAUSMAN-MILLER MD | ||||||||||||||
| CO-DENTAL DIRECTOR | $169,320 | $0 | $10,475 | $0 | $3,460 | $0 | $9,415 | $0 | $25,394 | $0 | $218,064 | $0 | $0 | $0 |
| RYAN BALLER DDS | ||||||||||||||
| CO-DENTAL DIRECTOR | $147,535 | $0 | $13,675 | $0 | $13,160 | $0 | $8,821 | $0 | $22,349 | $0 | $205,540 | $0 | $0 | $0 |
| DANIELLE ROSENKRANS MD | ||||||||||||||
| PHYSICIAN | $168,076 | $0 | $100 | $0 | $4,411 | $0 | $8,754 | $0 | $15,632 | $0 | $196,973 | $0 | $0 | $0 |
| JULIA HEATON MD | ||||||||||||||
| PHYSICIAN | $169,228 | $0 | $2,100 | $0 | $721 | $0 | $8,632 | $0 | $14,574 | $0 | $195,255 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART 1, LINE 7 | FormAndLineReferenceDesc |
| Explanation | NON-FIXED PAYMENTS THE BONUSES PAID TO EMPLOYEES ARE COMPUTED BASED ON PERFORMANCE, SUBJECT TO THE DISCRETION OF THE CEO. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WOODBURY COUNTY IOWA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 426005221 | BondIssuerEIN |
| Bond Issued | 2007-09-25 | BondIssuedDt |
| Issue Price | $7,000,000 | IssuePriceAmt |
| Purpose | CONSTRUCTION OF NEW FACILITY | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $0 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $7,000,000 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $100,000 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $6,900,000 | CapitalExpendituresAmt |
| Other Spent Proceeds | $0 | OtherSpentProceedsAmt |
| Unspent | $0 | UnspentAmt |
| Substantial Completion | 2009 | SubstantialCompletionYr |
| Current Refunding | false | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (true) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Remedial Action Taken | false | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | Yes (true) | NoRebateDueInd |
| Variable Rate Issue | Yes (true) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (true) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLS FARGO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 20. | TermOfHedgePct |
| Superintegrated Hedge | false | SuperintegratedHedgeInd |
| Hedge Terminated | false | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, LINE 2C | FormAndLineReferenceDesc |
| Explanation | NO REBATE DUE: THE COMPUTATION WAS PERFORMED AS OF 9/25/2012. | ExplanationTxt |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 8 | ContributionCnt |
| Noncash Contributions Rpt F990 | $696,685 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART I, LINE 20, COLUMN (B) | FormAndLineReferenceDesc |
| Explanation | NUMBER OF CONTRIBUTIONS: THE ORGANIZATION RECEIVED DRUGS AND MEDICAL SUPPLIES FROM 8 DIFFERENT DONORS THROUGHOUT THE YEAR. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 1 | ORGANIZATION'S MISSION: SIOUXLAND COMMUNITY HEALTH CENTER IS A NONPROFIT ORGANIZATION DEDICATED TO MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY AND SUPPORTS THE PHILOSOPHY OF THE PATIENT-CENTERED MEDICAL HOME. OUR VALUES INCLUDE WELCOMING, EXCELLENCE, COLLABORATION, ACCOUNTABILITY, RESPECT AND EMPATHY. |
| FORM 990, PART III, LINE 3 | NEW PROGRAM SERVICES: During FY 2014, Siouxland Community Health Center began providing prenatal services. These services include pregnancy tests, comprehensive prenatal care, and prenatal education with interpreters on-site. |
| FORM 990, PART III, LINE 4 | PROGRAM SERVICES: SIOUXLAND COMMUNITY HEALTH CENTER (SCHC) IS DEDICATED TO MEETING THE HEALTHCARE NEEDS OF THE SIOUXLAND AND IS A LEVEL THREE PATIENT CENTERED MEDICAL HOME. SCHC OFFERS THE FOLLOWING SERVICES: PRIMARY AND SPECIALTY MEDICAL SERVICES, LABORATORY, RADIOLOGY, HIV/AIDS AND HEPATITIS CARE, BEHAVIORAL HEALTH, PHARMACY, AND DENTAL SERVICES. SCHC PROVIDES FINANCIAL ASSISTANCE TO THE UNINSURED AND UNDERINSURED TO ELIMINATE ACCESS BARRIERS. |
| FORM 990, PART III, LINE 4A | PROGRAM SERVICE ACTIVITY #1: LABORATORY SIOUXLAND COMMUNITY HEALTH CENTER CURRENTLY CONDUCTS OVER 75% OF ITS LABORATORY TESTS ONSITE AND IS A MODERATE COMPLEX LABORATORY. FOR THOSE TESTS NOT PERFORMED ONSITE, THEY ARE SENT TO A REFERENCE LABORATORY WHERE THE MAJORITY OF TEST RESULTS ARE RETURNED WITHIN 24 HOURS. CONDUCTING THE MAJORITY OF TESTS ONSITE ENSURES RAPID TURNAROUND FOR DIAGNOSIS AND MONITORING OF CHRONIC MEDICAL CONDITIONS. THE LABORATORY WAS ACCREDITED BY THE JOINT COMMISSION FOR THE YEAR ENDING 1/31/15, THE LABORATORY PERFORMED 306,258 TESTS. RADIOLOGY SCHC ALSO CONDUCTS RADIOLOGY SERVICES. IT PERFORMED 3,909 EXAMS FOR THE YEAR ENDING 1/31/15. HIV/AIDS AND HEPATITIS THE HIV TEAM SERVES THE TRI-STATE SIOUXLAND AREA, AS WELL AS 20 NORTHWEST IOWA COUNTIES, 3 COUNTIES IN NEBRASKA, AND ONE COUNTY IN SOUTH DAKOTA. APPROXIMATELY 49% OF PATIENTS RECEIVING HIV/AIDS CARE LIVE IN RURAL AREAS. IN ADDITION TO MEDICAL CARE, THE HIV TEAM COORDINATES DENTAL CARE, CASE MANAGEMENT, TRANSPORTATION, AND HOUSING ASSISTANCE. FOR THE FISCAL YEAR ENDING 1/31/15, THE HIV TEAM SERVED 159 PATIENTS. FINANCIAL SERVICES TO ENSURE PATIENTS HAVE ACCESS TO CARE AT AN AFFORDABLE RATE, SCHC OFFERS A SLIDING FEE DISCOUNT TO PATIENTS BASED ON INCOME ELIGIBILITY AND ACCEPTS MEDICAID (TITLE 19), MEDICARE (TITLE 18), HAWK-I (STATE CHIP) AND MOST PRIVATE INSURANCES. IN 2014, 24% OF PATIENTS RECEIVING CARE WERE UNINSURED, 41% HAD COVERAGE BY MEDICAID/HAWK-I, 9% HAD MEDICARE COVERAGE, AND 26% HAD COVERAGE BY OTHER PAYERS. SCHC EMPLOYED FOUR CERTIFIED APPLICATION COUNSELORS TO ASSIST INDIVIDUALS WITH ENROLLMENT IN THE HEALTH INSURANCE EXCHANGE. |
| FORM 990, PART III, LINE 4B | PROGRAM SERVICE ACTIVITY #2: THE SCHC PHARMACY ALSO PARTICIPATES IN OTHER PHARMACEUTICAL ASSISTANCE PROGRAMS TO ENSURE PATIENTS HAVE ACCESS TO NEEDED PRESCRIPTION DRUGS. |
| FORM 990, PART VI, SECTION A, LINE 4 | SIGNIFICANT CHANGES: THE FOLLOWING SIGNIFICANT CHANGES WERE MADE TO THE ORGANIZATION'S BYLAWS DURING THE FISCAL YEAR: 2. MISSION STATEMENT THE MISSION OF THE ORGANIZATION IS TO SERVE OUR COMMUNITY TO BRING HEALING THROUGH OUR COMMITMENT TO CARE. 4.3 GOVERNING BODY, COMPOSITION The Chief Executive Officer may serve only as a non-voting, ex-officio member of the Board. 5.5 OFFICERS, VICE PRESIDENT IN THE ABSENCE OF OR THE INABILITY OR REFUSAL OF THE PRESIDENT TO ACT, THE VICE PRESIDENT SHALL PERFORM THE DUTIES AND EXERCISE THE POWERS OF THE PRESIDENT. THE VICE PRESIDENT SHALL ASSUME THE POSITION OF PRESIDENT OF THE BOARD WHEN THE TERM OF THE PERSON IN THAT POSITION EXPIRES OR IS VACATED. IF BOTH THE PRESIDENT AND VICE PRESIDENT ARE ABSENT FROM A MEETING OF THE BOARD, A PRESIDENT PRO TEM SHALL BE CHOSEN BY SIMPLE MAJORITY VOTE OF THE BOARD MEMBERS PRESENT AT SAID MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF THE FORM 990: 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. THE CEO AND CFO REVIEW THE RETURN BEFORE IT IS PRESENTED TO THE FINANCE COMMITTEE. THE FINANCE COMMITTEE APPROVES THE RETURN, AND THE FINANCE COMMITTEE CHAIR MAKES A RECOMMENDATION TO THE BOARD FOR APPROVAL OF THE FORM 990 FOR FILING WITH THE IRS. BOARD MEMBERS RECEIVE THE FORM 990 AS HARD COPIES (MAILED OR HAND-DELIVERED) OR ELECTRONIC FILES (SENT VIA E-MAIL). |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: A CONFLICT OF INTEREST POLICY IS STATED IN THE EMPLOYEE HANDBOOK. PER THE BYLAWS, IF A QUESTION CONCERNING A CONFLICT OF INTEREST FOR ANY DIRECTOR IS RAISED, A WRITTEN SECRET BALLOT MAY BE USED BY THE REMAINING DIRECTORS TO DETERMINE IF SUCH CONFLICT OF INTEREST EXISTS. SHOULD A CONFLICT OF INTEREST, PECUNIARY OR OTHERWISE, BE DETERMINED FOR ANY DIRECTOR, SUCH DIRECTOR SHALL BE EXCLUDED FROM VOTING ON THAT SUBJECT MATTER. A SIMPLE, AFFIRMATIVE MAJORITY OF THOSE PRESENT SHALL RULE. IN ALL EVENTS, A DIRECTOR SHALL DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | COMPENSATION REVIEW THE CEO'S COMPENSATION WAS EVALUATED IN 2014, BY THE BOARD OF DIRECTORS, USING A PEER REVIEW. EACH YEAR A SALARY ANALYSIS IS DONE USING DATA OBTAINED LOCALLY AND REGIONALLY. THIS ANALYSIS IS COMPILED AND A RECOMMENDATION IS TAKEN TO THE BOARD. THE ANALYSIS/RECOMMENDATIONS ARE GROUPED BY TITLE OF THE POSITION. THE CEO'S YEARLY EVALUATION IS PREPARED BY THE BOARD AND THE SCORE IS CALCULATED TO DETERMINE THE CURRENT YEAR SALARY. THE SAME PROCESS IS FOLLOWED FOR THE KEY EMPLOYEES, THE ONLY DIFFERENCE BEING THAT THE CEO DOES THE REVIEW. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS WILL BE PROVIDED TO INQUIRING PARTIES UPON REQUEST. |