2013-11-14T15:51:36-06:00 2013-02-28 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2012-03-01 391789874 KENOSHA COMMUNITY HEALTH CENTER INC KENO 2626560044 625 57TH STREET NO 700 KENOSHA WI 53140 JULIA HARRIS ROBINSON 2626560044 2013-11-14 1 DAVE GLOBIG P01356041 4144319300 2013-11-14 2012 2016-02-24 21:20:13Z JULIA HARRIS ROBINSON 625 57TH STREET NO 700 KENOSHA WI 53140 12082263 0 X WWW.KENOSHACHC.ORG X 1994 WI TO PROVIDE ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES AND TO REDUCE HEALTH DISPARITIES FOR THE UNDERSERVED PEOPLE OF KENOSHA COUNTY, WI, WITHOUT REGARD TO ABILITY TO PAY AND IN A SUSTAINABLE MANNER. 11 11 182 31 79949 -5998 4007947 1670762 8533323 10171164 1029 491 19271 239846 12561570 12082263 630 0 0 0 7053326 8196343 0 0 0 2878898 3988905 9932854 12185248 2628716 -102985 10577632 10407749 4064627 3997729 6513005 6410020 TO PROVIDE ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES AND TO REDUCE HEALTH DISPARITIES FOR THE UNDERSERVED PEOPLE OF KENOSHA COUNTY, WI, WITHOUT REGARD TO ABILITY TO PAY AND IN A SUSTAINABLE MANNER. 0 0 2992485 3098258 INCREASE ACCESS TO COMPREHENSIVE MEDICAL AND BEHAVIORAL HEALTH CARE FOR MEDICAID ENROLLEES AND THE UNINSURED. 6022777 7232803 INCREASE ACCESS TO COMPREHENSIVE DENTAL CARE FOR MEDICAID ENROLLEES AND THE UNINSURED. 9015262 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 11 0 1 182 1 1 1 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X RIA CROOK 2626560044 625 57TH STREET SUITE 700 KENOSHA WI 53140 CYNTHIA H JOHNSON 1.00 X 0 0 0 JO A WYNN 1.00 X 0 0 0 JACKIE BUSH 1.00 X 0 0 0 DANIEL HEYDEN 1.00 X 0 0 0 LORETTE MITCHELL 1.00 X 0 0 0 SHEBANIAH MUHAMAD 1.00 X 0 0 0 ANGELA CUNNINGHAM 1.00 X 0 0 0 AHMAD LANDRUM 1.00 X 0 0 0 JAY A CASHMORE 1.00 X X 0 0 0 LATASHA JONES 1.00 X X 0 0 0 PAMELA HALBACH 1.00 X X 0 0 0 FRANK LUDOWISE 1.00 X X 0 0 0 JACK WATERS 40.00 X 124491 0 6885 BETH RUHLAND 40.00 X 113058 0 14666 DAVID HUGHES 40.00 X 148495 0 13144 ALESSANDRO SAVAGLIO JR 40.00 X 273725 0 12780 UMAIR SHARIH 40.00 X 167313 0 18409 BRADLEY SMITH 40.00 X 171949 0 6247 PRZEMYSLAW KOLANKO 40.00 X 162209 0 22527 CARLOS MIRO 40.00 X 148329 0 5321 1309569 0 99979 18 0 1 0 PLEXUS HEALTH SOLUTIONS PO BOX 0655 KENOSHA WI 53141 A/R BILLING 271822 IN-HOUSE INFORMATION SYSTEMS 423 MELVIN AVE RACINE WI 53402 COMPUTER SUPPORT 212771 2 1565644 105118 1670762 PATIENT SERVICE FEES 621110 10083488 10083488 CONSULTING REVENUE 621110 79949 79949 MEDICAL RECORDS FEES 621110 7727 7727 10171164 491 491 MISCELLANEOUS REVENUE 900099 239846 239846 239846 12082263 10331061 79949 491 386044 386044 6307169 5016440 1290729 159518 123428 36090 773653 527339 246314 569959 416142 153817 116210 45921 70289 38835 3403 35432 633815 237742 396073 24808 22219 2589 1149905 1101280 48625 45106 22786 22320 441760 322970 118790 28770 9419 19351 40595 18423 22172 143775 143775 774218 723981 50237 19856 13618 6238 DUES & SUBSCRIPTIONS 17854 3333 14521 POSTAGE AND SHIPPING 6959 5852 1107 PATIENT EDUCATION 1446 1446 504993 399520 105473 12185248 9015262 3169986 0 704741 1183947 296000 100000 2009635 2039168 233396 118729 8880790 2138880 7169601 6741910 164259 223995 10577632 10407749 1055691 967804 8936 29925 3000000 3000000 4064627 3997729 X 6513005 6316951 0 93069 6513005 6410020 10577632 10407749 -102985 0 X 0 1 X 1 1 1 X 1117838 1793227 1397441 4007947 1670762 9987215 1117838 1793227 1397441 4007947 1670762 9987215 9987215 4978 3971 1461 1029 491 11930 9999145 32783053 0.99880 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 93069 93069 1.00000 0.00000 0.00000 0 0 159200 159200 5705785 1657397 4048388 2993613 481483 2512130 22192 22192 6741910 X 12082263 0 12082263 0 12082263 12185248 0 12185248 0 12185248 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUND IS TO SUPPORT THE HIRING OF TWO CASE MANAGERS TO PROVIDE MENTAL HEALTH SERVICES FOR THE MENTALLY ILL SO THAT THIS POPULATION CAN ACCESS PRIMARY MEDICAL AND DENTAL CARE SERVICES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS FASB ASC 740-10, INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS A FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. TAX RETURNS FOR TAX YEARS 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE APPLICABLE TAXING AUTHORITY. X X 0 0 0 0 0 0 0 0 0 DAVID HUGHES 108000 0 39721 0 774 0 5949 0 7195 0 161639 0 0 0 ALESSANDRO SAVAGLIO JR 175000 0 87282 0 11443 0 10932 0 1848 0 286505 0 0 0 UMAIR SHARIH 155251 0 8262 0 3800 0 6780 0 11629 0 185722 0 0 0 BRADLEY SMITH 167530 0 4005 0 414 0 2934 0 3313 0 178196 0 0 0 PRZEMYSLAW KOLANKO 162047 0 0 0 162 0 6642 0 15885 0 184736 0 0 0 CARLOS MIRO 135894 0 12435 0 0 0 5321 0 0 0 153650 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM IS REVIEWED BY THE BOARD FINANCE COMMITTEE BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL NEW BOARD MEMBERS TO SIGN A CONFLICT OF INTEREST STATEMENT. BOARD MEMBERS ARE REQUIRED TO UPDATE THESE STATEMENTS ANNUALLY. SHOULD A CONFLICT ARISE, THE PERSON AFFECTED IS ASKED TO EXCUSE THEMSELVES FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES A VARIETY OF REGIONAL AND EXECUTIVE RECRUITING FIRMS FOR KEY EMPLOYEES WHO RECOMMEND COMPENSATION PACKAGES BASED ON MARKET DATA. THE ORGANIZATION ALSO PARTICIPATES IN A VARIETY OF COMPENSATION SURVEYS THROUGH NACHC, WPHCA, AND GENERALIST HR ORGANIZATIONS AND RECEIVE THOSE REPORTS. THERE ARE ALSO PERIODIC SPOT CHECKS LOCALLY FOR SPECIFIC POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST KCHC REAL ESTATE LLC 4536 22ND AVENUE KENOSHA WI 53140 391789874 REAL ESTATE HOLDING WI 232629 3396332 KENOSHA COMMUNITY HEALTH CENTER INC