2015-11-13T12:23:53-06:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2014-01-01 043634356 BOUNDARY REGIONAL HEALTH CENTER INC BOUN 2082678422 301 CEDAR STREET NO 206 SANDPOINT ID 83864 KEVIN KNEPPER CHIEF FINANCIAL OFFICER 2082678422 2015-11-12 1 KYLA DELGADO CPA P01874220 4252506100 2014 2016-04-25 22:37:26Z X KANIKSU HEALTH SERVICE VICTORIA MCCLELLAN KING 301 CEDAR STREET NO 206 SANDPOINT ID 83864 6938302 0 X N/A X 2002 ID TO PROVIDE HIGH QUALITY, COST EFFECTIVE, CULTURALLY SENSITIVE HEALTH CARE SERVICES. 6 6 111 9 0 0 1955792 1700131 4636237 5052346 2 0 199017 185825 6791048 6938302 0 0 0 0 5097498 5487224 0 0 0 1425504 1908141 6523002 7395365 268046 -457063 3011168 2517089 2461212 2424196 549956 92893 THE MISSION OF KANIKSU HEALTH SERVICES IS TO PROVIDE HIGH QUALITY, COST EFFECTIVE, CULTURALLY SENSITIVE HEALTH CARE SERVICES. 0 0 4467967 0 3753893 KANIKSU HEALTH SERVICES (CENTER) PROVIDED MEDICAL VISITS TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED MEDICAL ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 996315 0 879108 KANIKSU HEALTH SERVICES (CENTER) PROVIDED DENTAL VISITS TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED DENTAL ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 475254 0 419345 KANIKSU HEALTH SERVICES (CENTER) PROVIDED BEHAVIORAL HEALTH SERVICES TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED BEHAVIORAL HEALTH ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 5939536 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 8 0 111 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X X KEVIN KNEPPER CFO 2082678422 301 CEDAR STREET NO 206 SANDPOINT ID 83864 RAY MILLER CHAIR 2.00 X X 0 0 0 SHEILA FARMINAUMICK VICE CHAIR 2.00 X X 0 0 0 SUSAN EDWARDS SECRETARY 2.00 X X 0 0 0 STEVE FOORD TREASURER 2.00 X X 0 0 0 JANET SHELBY DIRECTOR & TREASURER 2.00 X X 0 0 0 STEPHEN ACKER DIRECTOR 2.00 X 0 0 0 JOE ENGLISH DIRECTOR 2.00 X 0 0 0 MARY READER DIRECTOR 2.00 X 0 0 0 KRIS TAYLOR DIRECTOR 2.00 X 0 0 0 VICTORIA MCCLELLAN KING CHIEF EXECUTIVE OFFICER 40.00 X 98337 0 2501 KEVIN KNEPPER CHIEF FINANCIAL OFFICER 40.00 X 84989 0 2550 TOM LAWRENCE MD CHIEF MEDICAL OFFICER 40.00 X 180674 0 4983 NICK MILLER DO DENTIST 40.00 X 177039 0 5016 MARGERT RUSSELL MD PHYSICIAN 40.00 X 169340 0 0 JAMIE HETTICK MD PHYSICIAN 40.00 X 160361 0 4867 ADAM WEAVER DO DENTIST 40.00 X 148984 0 0 WARD LEEDY MD PHYSICIAN 40.00 X 143203 0 3803 1162927 0 23720 6 0 1 0 N IDAHO FAMILY PHYSICIANS 700 IRONWOOD DR 220E COEUR DALENE ID 83814 PHYSICIAN SERVICES 425143 KOOTENAI HEALTH 2003 KOOTENAI HEALTH WAY COEUR DALENE ID 83814 SOFTWARE SUPPORT 189963 2 1700131 1700131 PATIENT REVENUE, NET 621110 4868095 4868095 340B PHARMACY REVENUE 621110 184251 184251 5052346 MISCELLANEOUS REVENUE 561499 185825 185825 185825 6938302 5052346 0 185825 374034 312443 61591 4190870 3501053 689817 68811 57313 11498 497247 414157 83090 356262 296731 59531 45916 22540 23376 34 17 17 7143 3506 3637 447872 219860 228012 1998 1140 858 222127 198026 24101 237404 135486 101918 324394 291955 32439 82776 74741 8035 112843 101559 11284 23769 20180 3589 BAD DEBT 173149 173149 TRAINING COSTS 110182 40492 69690 EQUIPMENT MAINTENANCE 37531 35358 2173 LICENSES 35951 17616 18335 45052 22214 22838 7395365 5939536 1455829 0 180305 96773 705809 419785 56016 44211 2651353 695033 2069038 1956320 3011168 2517089 728441 681516 1732771 1742680 2461212 2424196 X 549956 92893 549956 92893 3011168 2517089 -457063 0 X 0 1 X 1 1 1 X 1702521 2441291 1718254 1955792 1700131 9517989 1702521 2441291 1718254 1955792 1700131 9517989 9517989 2 2 52845 18187 130149 199017 185825 586023 10104014 19752317 0.94200 0.95330 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME INCENTIVE PAYMENTS COMMUNITY EDUCATION MEDICAL RECORDS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 266881 266881 1708243 211904 1496339 95063 14259 80804 581166 468870 112296 1956320 X 6938302 0 6938302 0 6938302 7395365 0 7395365 0 7395365 PART X, LINE 2: THE CENTER HAS RECEIVED A DETERMINATION LETTER FROM THE IRS THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE CENTER'S TAX POSITIONS AND CONCLUDED THAT THE CENTER HAD TAKEN NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. X 0 0 X X X 0 0 0 1 0 0 0 0 0 TOM LAWRENCE MD CHIEF MEDICAL OFFICER 180674 0 0 0 0 0 4983 0 0 0 185657 0 0 0 NICK MILLER DO DENTIST 177039 0 0 0 0 0 5016 0 0 0 182055 0 0 0 MARGERT RUSSELL MD PHYSICIAN 169340 0 0 0 0 0 0 0 0 0 169340 0 0 0 JAMIE HETTICK MD PHYSICIAN 160361 0 0 0 0 0 4867 0 0 0 165228 0 0 0 PART I, LINE 1A A VISITING PHYSICIAN STAYED AT TOM LAWRENCE'S CABIN FOR SEVEN NIGHTS. THE AMOUNT PAID TO DR. LAWRENCE FOR USE OF THE WATER-FRONT CABIN, $1,200 TOTAL, WAS MUCH LESS THAN FAIR MARKET VALUE. PART I, LINE 5 ALL OF THE PROVIDERS, INCLUDING THE CMO, RECEIVED A BONUS BASED ON A COMBINATION OF GROSS REVENUES AND ENCOUNTER-LEVEL TARGETS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS REVIEWED BY THE CFO AND CEO, THEN PRESENTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE COMPLETED AND REVIEWED ANNUALLY FOR THE BOARD OF DIRECTORS AND KEY EMPLOYEEES. EACH INDIVIDUAL IS REQUIRED TO DISCLOSE ANY PERSONAL INTEREST WHICH THEY MAY HAVE IN ANY MATTER PENDING BEFORE THE ORGANIZATION AND REFRAINS FROM PARTICIPATION IN ANY DECISION ON SUCH MATTER. SUCH REFRAINING MAY TAKE THE FORM OF SIMPLE DISCLOSURE, LEAVING THE ROOM DURING DISCUSSION, NOT PARTICIPATING IN THE DISCUSSION, OR RECUSING ONESELF FROM THE ISSUE ALTOGETHER. FORM 990, PART VI, SECTION B, LINE 15 THE KANIKSU HEALTH SERVICES COMPENSATION MODEL - AS APPROVED BY THE BOARD OF DIRECTORS (BOD) - IS A COMPENSATION SCHEDULE BASED ON THE MOST RECENT NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTER (NACHC) REGION 10 (WASHINGTON, OREGON, IDAHO) COMPENSATION SURVEY BASED ON SIZE OF THE ORGANIZATION - ANNUAL REVENUES, SCOPE OF RESPONSIBILITY, YEARS OF EXPERIENCE AND EDUCATIONAL DEGREES, CERTIFICATIONS, ETC. ALL JOB CATEGORIES (INCLUDING CEO, OTHER OFFICERS AND KEY EMPLOYEES, ALL CLINICAL PROVIDERS AND ALL STAFF) HAVE AN ASSOCIATED COMPENSATION MODEL - THIS APPROACH HAS BEEN APPROVED BY THE BOD. THIS IS USED FOR ALL NEW HIRES AND IS EVALUATED ANNUALLY TO BE SURE THAT THERE IS INTERNAL EQUITY AMONG EMPLOYEES, ETC. THIS COMPENSATION MODEL IS ADJUSTED ANNUALLY BASED ON THE MOST RECENT NACHC DATA - RANGES OF SALARY ARE REVIEWED. IT IS THE GOAL OF KHS TO BE IN THE MEDIAN RANGE OF THE COMPENSATION MODEL - THIS APPROACH HAS BEEN APPROVED BY THE BOD. ANY ADJUSTMENTS MADE TO CURRENT EMPLOYEES ARE BASED ON AVAILABILITY OF BUDGET AS APPROVED BY THE BOD AND ARE DETERMINED BY "RANGE MOVEMENT" FOR STAFF POSITIONS AND FOR MAINTAINING COMPETITIVE RECRUITMENT AND RETENTION FOR PROVIDERS AS COMPARED TO THE OTHER COMMUNITY HEALTH CENTERS IN IDAHO AND IN REGION 10. DECISIONS ARE MADE BY THOSE WITHOUT CONFLICT AND THE DECISIONS ARE DOCUMENTED. THIS PROCESS WAS LAST COMPLETED IN 2015. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORMS 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE CONFLICT OF INTEREST POLICY OR GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE FEDERAL AUDIT CLEARINGHOUSE WEBSITE.