FURP.ORG / PUBLIC DATA EXPLORER

SIOUXLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
SIOUXLAND COMMUNITY HEALTH CENTER (EIN 42-1374894)
Tax period
2013-02-01 to 2014-01-31
Filed
2014-12-01
IRS object ID
201403359349300460
Schema version
2013v3.1
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

FieldValueIRS element (for citing)
Return2014-12-01T11:19:19-06:00ReturnTs
Tax Period End2014-01-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-02-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421374894EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SIOUXLAND COMMUNITY HEALTH CENTERBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of% JAN ANDERSONInCareOfNm
Business Name ControlSIOUBusinessNameControlTxt
Phone7122522477PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11021 NEBRASKA STREETAddressLine1
Address Line2SuiteAddressLine2
CitySIOUX CITYCity
StateIAState
ZIP Code511025410ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARI KAPTAIN-DAHLENPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone7122522477PhoneNum
Signature2014-11-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone7122522477PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARI KAPTAIN-DAHLENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11021 NEBRASKA STREETAddressLine1
CitySIOUX CITYCity
StateIAState
ZIP Code51102ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$19,667,722GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SLANDCHC.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO 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 Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee254TotalEmployeeCnt
Total Volunteers16TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,264,888PYContributionsGrantsAmt
CY Contributions Grants$5,693,098CYContributionsGrantsAmt
PY Program Service Revenue$13,623,385PYProgramServiceRevenueAmt
CY Program Service Revenue$13,962,776CYProgramServiceRevenueAmt
PY Investment Income$5,620PYInvestmentIncomeAmt
CY Investment Income$7,583CYInvestmentIncomeAmt
PY Other Revenue$2,799PYOtherRevenueAmt
CY Other Revenue$752CYOtherRevenueAmt
PY Total Revenue$18,896,692PYTotalRevenueAmt
CY Total Revenue$19,664,209CYTotalRevenueAmt
PY Grants And Similar Paid$74,134PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$66,750CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,446,412PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$12,530,743CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,045,576PYOtherExpensesAmt
CY Other Expenses$7,755,760CYOtherExpensesAmt
PY Total Expenses$18,566,122PYTotalExpensesAmt
CY Total Expenses$20,353,253CYTotalExpensesAmt
PY Revenues Less Expenses$330,570PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$689,044CYRevenuesLessExpensesAmt
Total Assets BOY$17,612,730TotalAssetsBOYAmt
Total Assets EOY$16,608,595TotalAssetsEOYAmt
Total Liabilities BOY$8,698,853TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,091,277TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,913,877NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,517,318NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO BE A PATIENT-CENTERED MEDICAL HOME THAT IMPROVES THE PHYSICAL, DENTAL, AND BEHAVIORAL HEALTH OF THE SIOUXLAND COMMUNITY WHILE ELIMINATING ACCESS BARRIERS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$10,461,583ExpenseAmt
Grant$66,750GrantAmt
Revenue$9,105,679RevenueAmt
DescPRIMARY AND SPECIALTY MEDICAL SERVICES IN FY 2013, SCHC PROVIDED MEDICAL SERVICES TO 19,070 PATIENTS (10% INCREASE FROM 2012). MEDICAL SERVICES WERE PROVIDED BY EIGHT PRIMARY CARE PHYSICIANS, EIGHT PHYSICIAN ASSISTANTS, FOUR NURSE PRACTITIONERS, AND A VARIETY OF VOLUNTEER SPECIALTY PROVIDERS FROM THE SIOUXLAND COMMUNITY. SPECIALTY CARE VOLUNTEERS PROVIDE THE FOLLOWING CARE: CARDIOVASCULAR, SURGERY, ORTHOPEDICS, PODIATRY, OPHTHALMOLOGY, PLASTIC SURGERY AND NEPHROLOGY. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,103,719ExpenseAmt
Revenue$2,701,452RevenueAmt
DescDENTAL CARE SCHC EMPLOYED FOUR AND A HALF FULL-TIME DENTISTS AND TWO DENTAL HYGIENISTS IN 2013 TO PROVIDE ROUTINE DENTAL CARE AND TREATMENT, ESPECIALLY FOR CHILDREN & INFANTS THROUGH AGE 21. ADULT EMERGENCY WALK-IN PATIENTS ARE ACCEPTED DAILY. THE DENTAL DEPARTMENT ALSO PROVIDES PRENATAL ORAL HEALTH EDUCATION, A MONTHLY BABY DAY CLINIC AND DENTAL OUTREACH. THE DENTAL DEPARTMENT SERVED 9,078 PATIENTS IN 2013 (3.1% INCREASE FROM 2012).Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$2,476,637ExpenseAmt
Revenue$2,155,645RevenueAmt
DescPHARMACY 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 EMPLOYS TWO FULL-TIME CLINICAL PHARMACISTS TO ASSIST PATIENTS WITH THEIR 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
FieldValueIRS element (for citing)
Total Program Service Expenses$16,041,939TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document26IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee254EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJAN ANDERSONPersonNm
Phone7122522477PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11021 NEBRASKA STREETAddressLine1
CitySIOUX CITYCity
StateIAState
ZIP Code51102ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
COREY WRENN
PRESIDENT ENDING 3/131.0Yes (X)Yes (X)
JENNIFER GOMEZ
DIRECTOR1.0Yes (X)
MARI KAPTAIN-DAHLEN
DIR END 5/13/CEO BEG 5/1340.0Yes (X)Yes (X)$72,486$0$0
BIBI JAURON
DIRECTOR1.0Yes (X)
JOAN KELLY
DIRECTOR1.0Yes (X)
GEORGE BOYKIN
DIRECTOR ENDING 7/131.0Yes (X)
NANCY METCALF
DIRECTOR/PRESIDENT BEG 3/131.0Yes (X)Yes (X)
OMAR SUAREZ
DIRECTOR1.0Yes (X)
KELLEY MCCARTHY
DIRECTOR1.0Yes (X)
DAVID OLSON
TREASURER1.0Yes (X)Yes (X)
CHAD MARKHAM
VICE PRESIDENT1.0Yes (X)Yes (X)
PERLA ALACORN-FLORY
SECRETARY BEGINNING 5/131.0Yes (X)Yes (X)
ANDREA BUCKLEY
DIRECTOR1.0Yes (X)
JOHNNY TUREAUD
DIRECTOR BEGINNING 6/131.0Yes (X)
DONA PRINCE
DIRECTOR BEGINNING 11/131.0Yes (X)
GEORGE MCGARY
DIRECTOR BEGINNING 6/131.0Yes (X)
MICHELLE STEPHAN RN BSN
CEO ENDING 5/1340.0Yes (X)$169,094$0$9,844
JAN ANDERSON CPA MBA
CFO40.0Yes (X)$133,600$0$21,973
MICHAEL PIPLANI MD
CMO BEGINNING 1/1440.0Yes (X)$0$0$0
JOSHUA SALANDER
COO BEGINNING 4/1340.0Yes (X)$90,509$0$15,728
THOR SWANSON MD
HIV MEDICAL DIRECTOR40.0$206,932$0$32,157Yes (X)
KRISTI WALZ MD
PHYSICIAN40.0$224,548$0$31,551Yes (X)
GARY HATTAN MD
PHYSICIAN40.0$222,180$0$31,702Yes (X)
STEPHEN PALLONE MD
PHYSICIAN40.0$192,378$0$29,060Yes (X)
DAVID FALDMO PA
PHYSICIAN ASSISTANT40.0$192,348$0$31,419Yes (X)
MARIA TUDOR MD
PHYSICIAN40.0$238,197$0$20,932Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,742,272TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$224,366TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K24IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

ServicesServicesDescCompensationCompensationAmt
INCONCERT CARE INC
COMPUTER SERVICES$229,372
MERCY MEDICAL CENTER SIOUX CITY
LABORATORY$221,120
TARGETED STRATEGIC PROJECTS
CONSTRUCTION MGT$212,540
FELDESMAN TUCKER LEIFER FIDELL
LEGAL$185,250
BKD LLP
AUDIT/TAX/CONSULTING$155,745
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Federated Campaigns$1,010FederatedCampaignsAmt
Fundraising$4,875FundraisingAmt
Government Grants$4,416,613GovernmentGrantsAmt
All Other Contributions$1,270,600AllOtherContributionsAmt
Noncash Contributions$1,364,059NoncashContributionsAmt
Total Contributions$5,693,098TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE624100$13,634,277$13,634,277
EHR INCENTIVE REVENUE624100$246,500$246,500
OTHER REVENUE624100$81,999$81,999
FieldValueIRS element (for citing)
Total Program Service Revenue$13,962,776TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,583TotalRevenueColumnAmt
Exclusion$7,583ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$4,265FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$4,875ContriRptFundraisingEventAmt
Fundraising Direct Expenses$3,513FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$752TotalRevenueColumnAmt
Exclusion$752ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,664,209TotalRevenueColumnAmt
Related Or Exempt Func Income$13,962,776RelatedOrExemptFuncIncomeAmt
Exclusion$8,335ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$66,750TotalAmt
Program Services$66,750ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$792,707TotalAmt
Program Services$257,244ProgramServicesAmt
Management And General$535,463ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,671,309TotalAmt
Program Services$7,910,041ProgramServicesAmt
Management And General$1,761,268ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$353,855TotalAmt
Program Services$290,353ProgramServicesAmt
Management And General$63,502ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$963,027TotalAmt
Program Services$783,073ProgramServicesAmt
Management And General$179,954ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$749,845TotalAmt
Program Services$602,744ProgramServicesAmt
Management And General$147,101ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$202,802TotalAmt
Management And General$202,802ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$138,247TotalAmt
Management And General$138,247ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,242,627TotalAmt
Program Services$1,193,032ProgramServicesAmt
Management And General$49,595ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$156,615TotalAmt
Program Services$28,234ProgramServicesAmt
Management And General$128,381ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$387,930TotalAmt
Program Services$127,915ProgramServicesAmt
Management And General$260,015ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$79,792TotalAmt
Program Services$57,062ProgramServicesAmt
Management And General$22,730ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$154,594TotalAmt
Program Services$35,626ProgramServicesAmt
Management And General$118,968ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$73,528TotalAmt
Program Services$17,740ProgramServicesAmt
Management And General$55,788ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$152,074TotalAmt
Program Services$95,586ProgramServicesAmt
Management And General$56,488ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$309,403TotalAmt
Management And General$309,403ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$743,862TotalAmt
Program Services$580,626ProgramServicesAmt
Management And General$163,236ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$34,788TotalAmt
Management And General$34,788ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT$1,158,473$1,158,473
MEDICAL SUPPLIES & DRUGS$2,821,016$2,821,016
LICENSES, DUES, SUBSCRIPTIONS$75,283$16,424$58,859
RECRUITING & RETENTION$12,021$12,021

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$12,705TotalAmt
Management And General$12,705ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$20,353,253TotalAmt
Program Services$16,041,939ProgramServicesAmt
Management And General$4,311,314ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,796BOYAmt
EOY$193,131EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,649,428BOYAmt
EOY$2,248,005EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$239,598BOYAmt
EOY$522,183EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,492,732BOYAmt
EOY$1,221,770EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$424,205BOYAmt
EOY$304,771EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$315,224BOYAmt
EOY$132,875EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$15,594,900LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,689,040LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,487,747BOYAmt
EOY$11,905,860EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$80,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$17,612,730BOYAmt
EOY$16,608,595EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,156,776BOYAmt
EOY$1,341,285EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,001,516BOYAmt
EOY$5,719,168EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$284,584BOYAmt
EOY$157,332EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,255,977BOYAmt
EOY$873,492EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,698,853BOYAmt
EOY$8,091,277EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,530,432BOYAmt
EOY$8,273,680EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$383,445BOYAmt
EOY$243,638EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,913,877BOYAmt
EOY$8,517,318EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,612,730BOYAmt
EOY$16,608,595EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$689,044ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$292,485NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,932,289CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,189,538CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,775,866CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,264,888CurrentTaxYearMinus1YearAmt
Current Tax Year$5,693,098CurrentTaxYearAmt
Total$25,855,679TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,932,289CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,189,538CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,775,866CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,264,888CurrentTaxYearMinus1YearAmt
Current Tax Year$5,693,098CurrentTaxYearAmt
Total$25,855,679TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$25,855,679PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,863CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,307CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,939CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,620CurrentTaxYearMinus1YearAmt
Current Tax Year$7,583CurrentTaxYearAmt
Total$36,312TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$25,891,991TotalSupportAmt
Gross Receipts Rltd Activities$60,258,922GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99860PublicSupportCY170Pct
Public Support PY1700.86795PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1(I)FormAndLineReferenceDesc
ExplanationTHE 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

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,197,727OtherCostOrOtherBasisAmt
Book Value$1,197,727BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,550,128OtherCostOrOtherBasisAmt
Depreciation$2,220,100DepreciationAmt
Book Value$8,330,028BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,784,655OtherCostOrOtherBasisAmt
Depreciation$1,468,940DepreciationAmt
Book Value$1,315,715BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,062,390OtherCostOrOtherBasisAmt
Book Value$1,062,390BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,905,860TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescINTEREST RATE SWAPDesc
Amt$873,492Amt
FieldValueIRS element (for citing)
Total Liability$873,492TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$18,963,016TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$292,485NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$21,475DonatedServicesAndUseFcltsAmt
Other Revenue-$1,018,666OtherRevenueAmt
Revenue Not Reported-$704,706RevenueNotReportedAmt
Revenue Subtotal$19,667,722RevenueSubtotalAmt
Other Revenues Not Included-$3,513OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$3,513RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$19,664,209TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$19,219,768TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$21,475DonatedServicesUseFcltsAmt
Other Expenses Included$3,513OtherExpensesIncludedAmt
Expenses Not Reported$24,988ExpensesNotReportedAmt
Expenses Subtotal$19,194,780ExpensesSubtotalAmt
Other Expenses Not Included$1,158,473OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,158,473ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$20,353,253TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2MANAGEMENT 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 2DAMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12 BAD DEBT EXPENSE $( 1,158,473) DECREASE IN TEMPORARILY RESTRICTED NET ASSETS 139,807 ------------ $( 1,018,666)
SCHEDULE D, PART XI, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 SPECIAL EVENT EXPENSES $( 3,513)
SCHEDULE D, PART XII, LINE 2DAMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25 SPECIAL EVENT EXPENSES $ 3,513
SCHEDULE D, PART XII, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1 BAD DEBT EXPENSE $ 1,158,473

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1NEBRASKA AIDS PROJECTBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 S 77TH ST STE AAddressLine1
CityOMAHACity
StateNEState
ZIP Code68114ZIPCode
FieldValueIRS element (for citing)
Recipient EIN470786622RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$66,750CashGrantAmt
Purpose Of GrantHIV PART B & HUD HOUSINGPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationMONITORING 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.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MICHELLE STEPHAN RN BSN
CEO ENDING 5/13$169,094$0$0$0$0$0$3,763$0$6,081$0$178,938$0$0$0
KRISTI WALZ MD
PHYSICIAN$215,467$0$1,039$0$8,042$0$11,273$0$20,278$0$256,099$0$0$0
GARY HATTAN MD
PHYSICIAN$211,305$0$10,825$0$50$0$11,129$0$20,573$0$253,882$0$0$0
STEPHEN PALLONE MD
PHYSICIAN$191,103$0$1,225$0$50$0$9,862$0$19,198$0$221,438$0$0$0
DAVID FALDMO PA
PHYSICIAN ASSISTANT$180,566$0$8,816$0$2,966$0$9,756$0$21,663$0$223,767$0$0$0
JAN ANDERSON CPA MBA
CFO$132,467$0$1,083$0$50$0$6,795$0$15,178$0$155,573$0$0$0
THOR SWANSON MD
HIV MEDICAL DIRECTOR$205,301$0$1,581$0$50$0$10,459$0$21,698$0$239,089$0$0$0
MARIA TUDOR MD
PHYSICIAN$218,252$0$1,104$0$18,841$0$11,893$0$9,039$0$259,129$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART 1, LINE 7FormAndLineReferenceDesc
ExplanationNON-FIXED PAYMENTS THE BONUSES PAID TO EMPLOYEES ARE COMPUTED BASED ON PERFORMANCE, SUBJECT TO THE DISCRETION OF THE CEO. BONUSES ARE ALSO COMPUTED IF THE EMPLOYEE IS "CAPPED" ON THEIR SALARY RANGE.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WOODBURY COUNTY IOWABusinessNameLine1
FieldValueIRS element (for citing)
Bond Issuer EIN426005221BondIssuerEIN
Bond Issued2007-09-25BondIssuedDt
Issue Price$7,000,000IssuePriceAmt
PurposeCONSTRUCTION OF NEW FACILITYPurposeDesc

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$0RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$7,000,000TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$100,000IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$0WorkingCapitalExpendituresAmt
Capital Expenditures$6,900,000CapitalExpendituresAmt
Other Spent Proceeds$0OtherSpentProceedsAmt
Unspent$0UnspentAmt
Substantial Completion2009SubstantialCompletionYr
Current RefundingfalseCurrentRefundingInd
Advance RefundingfalseAdvanceRefundingInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Bond Iss Meet Prvt Sec Pymt TestYes (true)BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DueYes (true)NoRebateDueInd
Variable Rate IssueYes (true)VariableRateIssueInd
Hedge Identified In Bks And RecYes (true)HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line1WELLS FARGOBusinessNameLine1
FieldValueIRS element (for citing)
Term Of Hedge20.TermOfHedgePct
Superintegrated HedgefalseSuperintegratedHedgeInd
Hedge TerminatedfalseHedgeTerminatedInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE K, PART IV, LINE 2CFormAndLineReferenceDesc
ExplanationNO REBATE DUE THE COMPUTATION WAS PERFORMED AS OF 9/25/2012.ExplanationTxt

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp
Clothing And Household GoodsClothingAndHouseholdGoodsGrp
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp
Securities Publicly TradedSecuritiesPubliclyTradedGrp
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp
CollectiblesCollectiblesGrp
Food InventoryFoodInventoryGrp

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution10ContributionCnt
Noncash Contributions Rpt F990$1,363,378NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescCONCERT TICKETSDesc
Contribution1ContributionCnt
Noncash Contributions Rpt F990$681NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE M, PART I, LINE 20, COLUMN (B)FormAndLineReferenceDesc
ExplanationNUMBER OF CONTRIBUTIONS THE ORGANIZATION RECEIVED DRUGS AND MEDICAL SUPPLIES FROM 10 DIFFERENT DONORS THROUGHOUT THE YEAR.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 1ORGANIZATION'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 MISSION IS TO BE A PATIENT-CENTERED MEDICAL HOME THAT IMPROVES THE PHYSICAL, DENTAL, AND BEHAVIORAL HEALTH OF THE SIOUXLAND COMMUNITY WHILE ELIMINATING ACCESS BARRIERS. OUR VALUES INCLUDE COMMITMENT, ADVANCEMENT, RESPECT, EXCELLENCE, AND SUPPORT.
FORM 990, PART III, LINE 4PROGRAM 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. IN 2013, SCHC SERVED 24,536 PATIENTS (5% INCREASE FROM 2012).
FORM 990, PART III, LINE 4APROGRAM SERVICE ACTIVITY #1 LABORATORY SIOUXLAND COMMUNITY HEALTH CENTER CURRENTLY CONDUCTS OVER 90% 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 IS ACCREDITED BY THE JOINT COMMISSION. IN 2013, THE LABORATORY PERFORMED 276,991 TESTS. RADIOLOGY SCHC ALSO CONDUCTS RADIOLOGY SERVICES. IT PERFORMED 8,590 TESTS IN 2013. HIV/AIDS AND HEPATITIS THE HIV TEAM SERVES THE TRI-STATE SIOUXLAND AREA, AS WELL AS 18 NORTHWEST IOWA COUNTIES. APPROXIMATELY 40% 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. IN 2013, THE HIV TEAM SERVED 130. 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 2013, 26% OF PATIENTS RECEIVING CARE WERE UNINSURED, 42% HAD COVERAGE BY MEDICAID/HAWK-I, 12% HAD MEDICARE COVERAGE, AND 20% FROM OTHER PAYERS.
FORM 990, PART III, LINE 4CPROGRAM SERVICE ACTIVITY #3 THE HEALTH CENTER EMPLOYS AN INDIGENT PROGRAM COORDINATOR TO ASSIST WITH ELIGIBILITY DETERMINATION. THE SCHC PHARMACY ALSO PARTICIPANTS IN OTHER PHARMACEUTICAL ASSISTANCE PROGRAMS TO ENSURE PATIENTS HAVE ACCESS TO NEEDED PRESCRIPTION DRUGS.
FORM 990, PART VI, SECTION A, LINE 4SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS THE BYLAWS WERE AMENDED DURING THE YEAR. SIGNIFICANT CHANGES WERE: -THE MISSION STATEMENT WAS CONDENSED TO STATE THE FOLLOWING: TO BE A PATIENT-CENTERED MEDICAL HOME THAT IMPROVES THE PHYSICAL, DENTAL, AND BEHAVIORAL HEALTH OF THE SIOUXLAND COMMUNITY WHILE ELIMINATING ACCESS BARRIERS. - THE RANGE OF NUMBER OF MEMBERS CHANGED FROM 9-15 TO 9-25, WHO AS A GROUP, REPRESENT THE INDIVIDUALS BEING OR TO BE SERVED IN TERMS OF DEMOGRAPHIC FACTORS. -THE CEO MAY SERVE ONLY AS A NON-VOTING, EX-OFFICIO MEMBER OF THE BOARD. -THE TERM OF OFFICE CHANGED FROM NO MORE THAN 2 CONSECUTIVE THREE YEAR TERMS IN ADDITION TO PARTIAL TERMS TO NO MORE THAN 3 CONSECUTIVE FOUR YEAR TERMS WITH NO PARTIAL TERMS ALLOWED. -THE POWER OF FILLING VACANCIES CHANGED FROM THE NOMINATING COMMITTEE PROCESS TO THE BOARD DEVELOPMENT COMMITTEE PROCESS. THE ONE APPOINTED TO FILL A VACANCY WILL NOT ASSUME ANY UNEXPIRED PORTION OF THE PREVIOUS TERM. -THE ACT OF MAJORITY WAS ADDED TO STATE THAT UNLESS A GREATER NUMBER IS REQUIRED BY LAW, THE ACT OF A MAJORITY OF MEMBERS AT A MEETING WHERE THERE IS A QUORUM WILL BE THE ACT OF THE BOARD. -ATTENDANCE RULES WERE CHANGED FROM 3 UNEXCUSED ABSENCES IN SUCCESSION OR 4 UNEXCUSED ABSENCES IN A 12 MONTH PERIOD TO 4 CONSECUTIVE ABSENCES OR 3 UNEXCUSED ABSENCES IN A 12 MONTH PERIOD FROM REGULARLY SCHEDULED MEETINGS TO BE CAUSE FOR MEMBER STATUS TO BE REVIEWED RATHER THAN AUTOMATIC DISMISSAL. -THE REMOVAL OF A MEMBER BY A 2/3 VOTE OF THE ENTIRE BOARD WITH A 7 DAY WRITTEN NOTICE WAS ADDED. -THE REQUIREMENT OF A SIGNED STATEMENT REGARDING CONFIDENTIALITY AND CONFLICT AND DISCLOSURE OF INTEREST/AFFILIATION FORMS WAS ADDED TO THE CONFLICT OF INTEREST POLICY. - THE POWER OF MEMBERS TO DETERMINE THE DUTIES AND RESPONSIBILITIES OF OFFICERS FROM TIME TO TIME WAS ADDED. -THE ELECTION OF OFFICERS FOR A 2 YEAR TERM WAS ADDED. -THE POWER OF MEMBERS TO FILL AN OFFICER VACANCY FOR THE REMAINDER OF THE TERM WAS ADDED. -THE RESPONSIBILITY FOR REVIEWING FINANCIAL REPORTS MONTHLY, DEVELOPING INVESTMENT STRATEGIES, AND MONITORING OVERALL FINANCIAL WELFARE WAS ADDED TO THE FINANCE COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 11BREVIEW 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 PRIOR TO ITS SUBMISSION. A COPY OF THE 990 WILL BE DISTRIBUTED TO THE EXECUTIVE COMMITTEE MEMBERS PRIOR TO IT BEING FILED, WHILE ALL BOARD MEMBERS WILL RECEIVE A COPY OF THE 990 AFTER IT HAS BEEN FILED.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT 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 & 15BCOMPENSATION REVIEW THE CEO'S COMPENSATION WAS EVALUATED IN 2013, 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 19DOCUMENT DISCLOSURE THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS WILL BE PROVIDED TO INQUIRING PARTIES UPON REQUEST.