2014-10-29T13:10:15-05:00 2014-02-28 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2013-03-01 470548990 ONEWORLD COMMUNITY HEALTH CENTERS INC ONEW 4027344110 4920 SOUTH 30TH STREET NO 103 OMAHA NE 68107 ANDREA SKOLKIN CHIEF EXECUTIVE OFFICER 4027344110 2014-10-24 1 BARBARA J FAJEN P00400874 4023302660 2013 2015-11-30 17:44:51Z ANDREA SKOLKIN 4920 SOUTH 30TH STREET NO 103 OMAHA NE 68107 27455252 0 X WWW.ONEWORLDOMAHA.ORG X 1975 NE PRIMARY CARE SERVICES TO PATIENTS INCLUDE A FACE TO FACE VISIT WITH A MEDICAL PROVIDER TO ASSESS THEIR MEDICAL NEEDS. DENTAL SERVICES INCLUDE VISITS WITH DENTISTS OR HYGIENISTS TO PROVIDE TEETH CLEANING, ORAL EXAMS AND SOME RESTORATIVE SERVICES. BEHAVIORAL SERVICES INCLUDE PATIENTS SEEN BY THE BEHAVIORAL THERAPISTS AND PSYCHIATRISTS. PHARMACY SERVICES PROVIDE PRESCRIPTION MEDICATION TO ONEWORLD'S PATIENTS. ONEWORLD ALSO PROVIDES WIC SERVICES TO LOW INCOME MOTHERS AND CHILDREN AND OTHER SUPPORTIVE SERVICES. 14 14 354 32 0 0 21499068 14663616 8641341 10022549 149193 160112 1146551 1187495 31436153 26033772 542441 67277 0 0 11320076 13421370 0 0 429374 10646299 11565372 22508816 25054019 8927337 979753 24453496 25009533 3274403 2732129 21179093 22277404 X ONEWORLD COMMUNITY HEALTH CENTERS, IN PARTNERSHIP WITH THE COMMUNITY, PROVIDE CULTURALLY RESPECTFUL, QUALITY HEALTHCARE WITH SPECIAL ATTENTION TO THE UNDERSERVED. 0 0 11719811 49031 7493564 MEDICAL CLINIC - TO PROVIDE HEALTH CARE SERVICES TO UNDERSERVED INDIVIDUALS IN OMAHA, PLATTSMOUTH AND 3 SCHOOL BASED HEALTH CLINICS. FOR THIS CURRENT YEAR, ONEWORLD PROVIDED 67,219 VISITS TO 24,390 PATIENTS. 1977676 8274 1175080 THE DENTAL CLINIC CONTINUED TO GROW AND IT PROVIDED 16,873 VISITS TO 8,716 PATIENTS. 6816651 9972 836784 THE PHARMACY DEPARTMENT CONTINUED TO GROW RESULTING IN INCREASED PATIENT VOLUME. IN THIS CURRENT YEAR, IT PROVIDED 79,846 SCRIPTS. 2115199 1608003 OTHER PROGRAM SERVICES 2115199 1608003 22629337 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 1 33 0 1 354 1 0 0 0 0 0 1 1 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X TOM MCLAUGHLIN 4025028858 4920 SOUTH 30TH STREET 103 OMAHA NE 68107 ANDREW KLOECKNER BOARD CHAIR 2.00 0.00 X X 0 0 0 DONOVAN HUTCHENS VICE CHAIR 2.00 0.00 X X 0 0 0 BRENT BLUME TREASURER 2.00 0.00 X X 0 0 0 PAULA SCHULZ SECRETARY 2.00 0.00 X X 0 0 0 PAUL ESPOSITO MD BOARD MEMBER 2.00 0.00 X 0 0 0 BLANCA MEJIA BOARD MEMBER 2.00 0.00 X 0 0 0 HEATH MELLO BOARD MEMBER 2.00 0.00 X 0 0 0 JEREMY NORDQUIST BOARD MEMBER 2.00 0.00 X 0 0 0 DAVE RIDDER BOARD MEMBER 2.00 0.00 X 0 0 0 MARISELA RINCON BOARD MEMBER 2.00 0.00 X 0 0 0 GABE ROMERO BOARD MEMBER 2.00 0.00 X 0 0 0 DENNIS SNOOK BOARD MEMBER 2.00 0.00 X 0 0 0 DUSTIN ZABOKRTSKY BOARD MEMBER 2.00 0.00 X 0 0 0 MARCY ZAUNA BOARD MEMBER 2.00 0.00 X 0 0 0 ARMANDO SALGADO BOARD MEMBER (3/2013-6/2013) 2.00 0.00 X 0 0 0 ANDREA SKOLKIN CHIEF EXECUTIVE OFFICER 40.00 0.00 X 203135 0 28226 THOMAS MCLAUGHLIN CHIEF FINANCIAL OFFICER (7/2013 - PRESENT) 40.00 0.00 X 47639 0 5290 CAROLINA APICELLA CHIEF FINANCIAL OFFICER (3/2013-5/2013) 40.00 0.00 X 49700 0 4113 HENRY DETHLEFS PHYSICIAN 40.00 0.00 X 173674 0 23370 ALEX DWORAK PHYSICIAN 36.00 0.00 X 141356 0 21521 THERESE HENNESSY PHYSICIAN 30.00 0.00 X 140635 0 12858 KATIE SAGRERO PHYSICIAN 40.00 0.00 X 133026 0 19078 JOEL DOUGHERTY CHIEF OPERATING OFFICER 40.00 0.00 X 118923 0 11661 1008088 0 126117 13 0 1 0 LUND ROSS PO BOX 3688 OMAHA NE 68103 CONSTRUCTION FEES 790180 CUSTOM COMPUTING CORPORATION 11135 MILL VALLEY ROAD OMAHA NE 68154 BILLING SERVICES 363158 MCGINNIS CONSTRUCTION COMPANY 9 SOUTH 15TH STREET COUNCIL BLUFFS IA 51501 CONSTRUCTION FEES 227180 HEARTLAND COMMUNITY HEALTH NETWORK 4910 S 30TH STREET OMAHA NE 68107 MEDICAL SERVICES 212174 UNMC DEPT OF FAMILY MEDICINE 983075 NEBRASKA MEDICAL CENTER OMAHA NE 68198 MEDICAL SERVICES 206816 9 298479 46924 7664524 6653689 4448392 14663616 MEDICAL CLINIC 621990 7493564 7493564 DENTAL 621990 1175080 1175080 SCHOOL CLINICS 621990 370953 370953 BEHAVIORAL HEALTH PROGRAM 621990 242801 242801 740151 740151 10022549 165489 165489 33153 0 33153 33153 33153 5377 -5377 -5377 -5377 96295 46924 32835 63460 63460 2220052 1383268 836784 836784 SALARY REIMBURSEMENT 900099 175273 175273 INVOLUNTARY CONVERSION 900099 78825 78825 254098 26033772 11113431 0 256725 67277 67277 338103 338103 10855805 9949252 693615 212938 318755 285356 25569 7830 1054537 883770 143292 27475 854170 785258 68912 34371 34371 98204 98204 26344 26344 1459442 1220857 235510 3075 239363 35736 48604 155023 997589 833468 157452 6669 183028 146653 27156 9219 960341 960341 55876 33127 20144 2605 180094 119732 57486 2876 600399 590943 9456 76727 76727 PHARMACEUTICALS USED IN 4433151 4433151 BAD DEBT EXPENSE 1104950 1104950 LABORATORY 492498 492498 MEDICAL SUPPLIES 442806 442806 180189 133064 45461 1664 25054019 22629337 1995308 429374 3850 5500 7386976 6598508 2401239 1471551 417230 929231 465478 452842 145256 145891 405594 415259 14344279 4138416 9699461 10205863 2663431 3888982 324234 324358 540747 571548 24453496 25009533 2514428 2036837 523426 458743 236549 236549 3274403 2732129 X 19361929 19748444 1817164 2528960 21179093 22277404 24453496 25009533 979753 118558 0 X X 0 1 X 1 1 1 X 8485881 11199919 12214818 21499068 14663616 68063302 8485881 11199919 12214818 21499068 14663616 68063302 170116 67893186 147657 136672 143479 209059 198642 835509 301941 276461 245424 271568 1095394 69994205 44423092 0.97000 0.97070 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 33386 10000 4831 48217 21804 10000 1582 33386 11607 10000 197 21804 11000 607 11607 1.00000 0.00000 0.00000 1 0 7406791 201241 7205550 2739834 1005120 1734714 3501010 2574346 926664 696644 357709 338935 10205863 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 40549 LONG TERM NOTE PAYABLE 196000 236549 X PART X, LINE 2: ONEWORLD IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ONEWORLD HAS RECEIVED A DETERMINATION LETTER THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX-EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE ONEWORLD TO MEET A COMMUNITY BENEFIT STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. ONEWORLD ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC TOPIC 740, INCOME TAXES. ONEWORLD RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT FEBRUARY 28, 2014 AND 2013, ONEWORLD HAD NO UNCERTAIN TAX POSITIONS ACCRUED. WITH FEW EXCEPTIONS, ONEWORLD IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY U.S. FEDERAL, STATE OR LOCAL AUTHORITIES FOR YEARS BEFORE 2010. MILAGRO DINNER 123299 42704 80595 1536 15412 5000 3646 CINCO 2013 19920 4220 15700 4164 657 2420 143219 46924 96295 5700 16069 5000 6066 32835 63460 1 CAB RIDES, SMALL MEDICAL SUPPLIES AND PRESCRIPTION DRUGS 1650 25876 FAIR MARKET VALUE CAB RIDES, SMALL MEDICAL SUPPLIES AND PRESCRIPTION DRUGS PART I, LINE 2: ONEWORLD DETERMINES A PATIENT'S ELIGIBILITY FOR ASSISTANCE BY OBTAINING THE PATIENT'S INCOME INFORMATION. THE DONATION STATUS OR THE EXEMPTION FROM THE SLIDING FEE SCALE APPLIED TO PATIENT ACCOUNTS IS TO ASSIST THOSE PATIENTS WITHOUT THE MEANS TO PAY FOR MEDICAL CARE. THE FINANCIAL STATUS OF THE PATIENT IS ASSESSED AT A MEETING WITH A FINANCIAL COUNSELOR. THE PATIENT PROVIDES DOCUMENTATION OF FINANCIAL HARDSHIP FOR DISCUSSION AT THAT MEETING. IF THE FINANCIAL COUNSELOR DETERMINES THAT IS NOT POSSIBLE FOR THE PATIENT TO PAY, THEN THE PATIENT MEETS WITH A SOCIAL SERVICES REPRESENTATIVE TO DETERMINE IF THE PATIENT QUALIFIES FOR DONATION STATUS. AS A TOOL AND TO MAINTAIN CONSISTENCY, THE SOCIAL SERVICES DEPARTMENT REPRESENTATIVE USES THE DONATION STATUS QUESTIONNAIRE TO MAKE THE ASSESSMENT. THE PATIENT CAN QUALIFY FOR DONATION STATUS FOR A PERIOD OF 1 TO 3 MONTHS. A REPORT DETAILING THE PATIENTS QUALIFYING FOR DONATION STATUS IS REVIEWED MONTHLY BY THE CFO AND CEO OF ONEWORLD. X X X X X 0 0 0 0 0 1 0 0 0 ANDREA SKOLKIN CHIEF EXECUTIVE OFFICER 169119 0 33500 0 516 0 9369 0 18857 0 231361 0 0 0 HENRY DETHLEFS PHYSICIAN 173494 0 0 0 180 0 8116 0 15254 0 197044 0 0 0 ALEX DWORAK PHYSICIAN 140268 0 1000 0 88 0 6612 0 14909 0 162877 0 0 0 THERESE HENNESSY PHYSICIAN 140169 0 0 0 466 0 6369 0 6489 0 153493 0 0 0 KATIE SAGRERO PHYSICIAN 132941 0 0 0 85 0 4157 0 14921 0 152104 0 0 0 PART I, LINE 6 THE CHIEF EXECUTIVE OFFICER RECEIVED A BONUS FOR 2013 THAT WAS CONTINGENT ON THE FOLLOWING 5 FACTORS EQUALLY: 1) EMPLOYEE SATISFACTION 2) PATIENT SATISFACTION - OVERALL SCORE NOT UNDER 85% 3) NET OPERATING MARGIN BEFORE DEPRECIATION 4) AUDIT - UNQUALIFIED OPINION, NO MATERIAL WEAKNESSES 5) GOALS: NEW STRATEGIC PLAN, ENGAGED COMMUNITY ADVISORY GROUP, ENGAGED BOARD, ESTABLISH LEADERSHIP TRAINING FOR STAFF, SCHOOL CLINICS OPERATION. X 636 4448392 FAIR MARKET VALUE 0 1 0 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTIONS IS THE NUMBER OF THE TYPES OF PHARMACEUTICALS RECEIVED. FORM 990, PART VI, SECTION B, LINE 11 BEFORE FILING FORM 990, A DRAFT IS PROVIDED TO THE CFO AND CEO FOR REVIEW. IF ANY CORRECTIONS OR CHANGES ARE NEEDED, THE CFO AND CEO COMMUNICATE THE CHANGES IN WRITING TO THE PREPARER. THE PREPARER ISSUES A REVISED DRAFT OF FORM 990 AND IT IS PROVIDED TO THE FINANCE COMMITTEE FOR DISCUSSION AND REVIEW. UPON ACCEPTANCE BY THE FINANCE COMMITTEE, THE FORM IS PRESENTED TO THE BOARD FOR THE FINAL APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH NEW EMPLOYEE AND NEW BOARD MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY. THE POLICY IS ALSO REVISITED QUARTERLY AT EACH STAFF MEETING TO REMIND EMPLOYEES TO REPORT ANY TRANSACTIONS RESULTING IN CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION STRUCTURES AT ONEWORLD ARE REVIEWED AND APPROVED ANNUALLY. THE PROCESS BEGINS WITH AN ANNUAL SALARY COMPARISON ACROSS NATIONAL, REGIONAL, AND LOCAL SALARY SURVEYS AND ONEWORLD'S SALARY RANGE STRUCTURES. IF ADJUSTMENTS ARE NEEDED FOR ANY RANGE TO REMAIN COMPETITIVE AGAINST THE MARKET, SUCH CHANGES ARE SUGGESTED AND REVIEWED FOR APPROVAL BY THE COMPENSATION COMMITTEE AND THE ENTIRE BOARD. ONEWORLD USES THE FOLLOWING PUBLISHED SALARY SURVEYS FOR COMPARISON: NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, NON-PROFIT ASSOCIATION OF THE MIDLANDS, HUMAN RESOURCE ASSOCIATION OF THE MIDLANDS, AND THE MEDICAL GROUP MANAGEMENT ASSOCIATION. ONEWORLD POSITION DESCRIPTIONS ARE COMPARED AGAINST THE SURVEY POSITION DESCRIPTIONS AND LIKE POSITION SALARIES ARE COMPARED AGAINST THE 25TH AND 75TH PERCENTILES OF SURVEY DATA. IF THERE ARE LARGE CHANGES IN THE MARKET FOR A POSITION, THIS INFORMATION IS ASSESSED AND A DETERMINATION IS MADE IF OUR RANGE IS COMPETITIVE OR SHOULD BE ADJUSTED. ONCE SURVEY ASSESSMENT IS COMPLETE, RECOMMENDATIONS ARE SENT TO THE ONEWORLD BOARD OF DIRECTORS FOR APPROVAL OF SALARY RANGES BY POSITION FOR THE YEAR. IN CONSIDERATION OF A SPECIFIC POSITION, SPECIFIC EMPLOYEE OR SPECIFIC CANDIDATE; ONEWORLD WILL TAKE INTO ACCOUNT ONE'S EXPERIENCE, EDUCATION, AND LEVEL OF RESPONSIBILITY TO DETERMINE WHERE ONE'S SALARY WOULD BE WITHIN THE APPROVED SALARY RANGE. POSITION DESCRIPTIONS ARE REVIEWED AND UPDATED EACH YEAR DURING ANNUAL REVIEWS IN THE EARLY SPRING. THE ANNUAL REVIEW OF SALARY RANGES TAKES PLACE IN THE LATE FALL/ EARLY WINTER OF EACH YEAR WITH BOARD APPROVAL BY FEBRUARY OF EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CURRENTLY, WE ARE WORKING ON A WEBSITE THAT WILL ULTIMATELY PUBLISH THIS INFORMATION FOR PUBLIC USE. FORM 990, PART XI, LINE 2C: THERE HAVE BEEN NO CHANGES FROM THE PRIOR YEAR. THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT ACCOUNTANT AND HAS THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. UPON CONCLUSION OF THE AUDIT, THE AUDITING FIRM PRESENTS THE RESULTS AND FINDINGS TO THE AUDIT COMMITTEE AND THE BOARD OF DIRECTORS. ONEWORLD COMMUNITY BUILDERS LLC 4980 S 30TH STREET SUITE 103 OMAHA NE 68107 270791687 FACILITY DEVELOPMENT NE 0 0 ONEWORLD COMMUNITY HEALTH CENTERS INC ONEWORLD EXCHANGE LLC 4980 S 30TH STREET SUITE 103 OMAHA NE 68107 463690550 FACILITY DEVELOPMENT NE 0 0 ONEWORLD COMMUNITY HEALTH CENTERS INC LIVESTOCK COMMONS LLC 4980 S 30TH STREET SUITE 103 OMAHA NE 68107 270831017 LOW INCOME HOUSING NE N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0