FURP.ORG / PUBLIC DATA EXPLORER

LEMARS AREA DIALYSIS SERVICES: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
LEMARS AREA DIALYSIS SERVICES (EIN 20-4980796)
Tax period
2012-07-01 to 2013-06-30
Filed
2013-09-17
IRS object ID
201312609349300626
Schema version
2012v2.1
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)
Timestamp2013-09-17T14:22:59-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WILLIAMS & COMPANY PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line121 1ST AVENUE NWAddressLine1
CityLE MARSCity
StateIAState
ZIP Code51031ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN204980796EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LE MARS AREA DIALYSIS SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLEMANameControl
Phone7125467871Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 - 1ST ST SWAddressLine1
CityLE MARSCity
StateIAState
ZIP Code51031ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMIKE DONLINName
TitlePRESIDENTTitle
Phone7125467871Phone
Date Signed2013-08-01DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJEFFREY S PETERS CPAName
Phone7125467801Phone
Date Prepared2013-09-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMIKE DONLINNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1714 LINCOLN ST NEAddressLine1
CityLE MARSCity
StateIAState
ZIP Code51031ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1470611GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2006YearFormation
State Legal DomicileIAStateLegalDomicile
Activity Or Mission DescriptionTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURROUNDING REGION.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year2990ContributionsGrantsPriorYear
Contributions Grants Current Year295518ContributionsGrantsCurrentYear
Program Service Revenue Prior Year43771ProgramServiceRevenuePriorYear
Program Service Revenue CY1163951ProgramServiceRevenueCY
Investment Income Prior Year11InvestmentIncomePriorYear
Investment Income Current Year29InvestmentIncomeCurrentYear
Other Revenue Current Year7138OtherRevenueCurrentYear
Total Revenue Prior Year46772TotalRevenuePriorYear
Total Revenue Current Year1466636TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year575673OtherExpensePriorYear
Other Expenses Current Year911919OtherExpensesCurrentYear
Total Expenses Prior Year575673TotalExpensesPriorYear
Total Expenses Current Year911919TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-528901RevenuesLessExpensesPriorYear
Revenues Less Expenses CY554717RevenuesLessExpensesCY
Total Assets BOY1667911TotalAssetsBOY
Total Assets EOY1621824TotalAssetsEOY
Total Liabilities BOY887867TotalLiabilitiesBOY
Total Liabilities EOY287063TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY780044NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1334761NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURROUNDING REGION.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense743400Expense
DescriptionTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURROUNDING REGIONDescription

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense137488Expense
DescriptionTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURRONDING REGION.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp137488TotalOfOtherProgramServiceExp
Total Program Service Expense880888TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMIKE DONLINNamePerson
Telephone Number7125463492TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1714 LINCOLN ST NEAddressLine1
CityLE MARSCity
StateIAState
ZIP Code51031ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
KIRK KLOHS
TREASURER1.00XX000
JAMES GEORGE
DIRECTOR1.00XX000
KAREN DRECKMAN
SECRETARY1.00XX000
RANDY REARDON
CHAIR1.00XX000
LE ANN ARENS
DIRECTOR1.00X000
MIKE DONLIN
PRESIDENT1.00X000
DR LIEM-SOM OEI
MEDICAL DIRE1.00XX000
FieldValueIRS element (for citing)
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1FRESENIUS MEDICAL CAREBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1920 WINTER STREETAddressLine1
CityWALTHAMCity
StateMAState
ZIP Code02451ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesMEDICALDescriptionOfServices
Compensation346562Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions295518AllOtherContributions
Total Contributions295518TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
WELLMARK621500364230364230
MEDICARE621500320433320433
AVERA HEALTH PLAN621500252127252127
UNITED HEALTH CARE6215009460894608
SIOUXLAND PACE6215004350043500

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column89053TotalRevenueColumn
Related Or Exempt Function Income89053RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue1163951TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column29TotalRevenueColumn
Exclusion$29ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events11067GrossIncomeFundraisingEvents
Fundraising Direct Expenses3975FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column7092TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISC REVDescription
Total Revenue Column46TotalRevenueColumn
Related Or Exempt Function Income46RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue46TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1466636TotalRevenueColumn
Related Or Exempt Function Income1163997RelatedOrExemptFunctionIncome
Exclusion$29ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total73739Total
Program Services73739ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2278Total
Program Services2278ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total4710Total
Program Services4710ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total238802Total
Program Services238802ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total310Total
Program Services310ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5615Total
Program Services5615ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total19324Total
Program Services19324ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total20338Total
Program Services20338ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total12203Total
Program Services12203ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total137178Total
Program Services137178ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total7933Total
Program Services7933ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONTRACTED LABOR34656231595630606
REPAIRS & MAINTENANCE2854228542
SUPPLIES1002710027
LEASED EQUIPMENT31623162

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1196Total
Program Services771ProgramServices
Management And General425ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total911919Total
Program Services880888ProgramServices
Management And General31031ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY45915BOY
EOY149759EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY59000BOY
EOY19500EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3620BOY
EOY3620EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1695007LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec246078LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1559360BOY
EOY1448929EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY16BOY
EOY16EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1667911BOY
EOY1621824EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY288896BOY
EOY115632EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY598971BOY
EOY171431EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY887867BOY
EOY287063EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY780044BOY
EOY1334761EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY780044BOY
EOY1334761EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1667911BOY
EOY1621824EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses554717ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1304086OtherCostOrOtherBasis
Depreciation79713Depreciation
Book Value1224373BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis390921OtherCostOrOtherBasis
Depreciation166365Depreciation
Book Value224556BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1448929TotalOfBookValueLandBuildings

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ADDITIONAL INFORMATIONFORM 990SCHEDULE A PART I, LINE 3- LE MARS AREA DIALYSIS SERVICES DOES NOT MEET THE DEFINITION OF "HOSPITAL FACILITY" FOR PURPOSE OF THE SCHEDULE H
ALL OTHER ACCOMPLISHMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4DTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURRONDING REGION.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BFORM 990 IS PROVIDED TO THE GOVERNING BODY FOR REVIEW BEFORE IT IS FILED
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CTHE CENTER REQUIRES BOARD MEMBERS TO DISCLOSE AND REVIEW CONFLICTS OF INTEREST ANNUALLY
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE CLINIC MANAGER'S WAGE WAS APPROVED BY THE BOARD AFTER REVIEW OF WAGE AND SALARY DATA RECIEVED FROM FRESENIOUS MEDICAL CARE WHICH IS THE ENTITY THAT PAYS THE STAFF AT THE CENTER
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19ALL APPROPRIATE DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC INCLUDING FORM 990 & FORM 1023 APPLICATIONS DURING NORMAL BUSINESS HOURS AT THE LE MARS AREA DIALYSIS SERVICES OFFICE AT 714 LINCOLN ST NE PO BOX 10, LE MARS, IA 51031
OTHER FEES FOR SERVICESFORM 990, PART IX, LINE 11GMEDICAL SUPPLIES 236,590 0 0 MEDICAL WASTE EXPENSE 2,212 0 0
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 9PLYMOUTH COUNTY LOAN 0 CITY OF LE MARS LOAN 0 PLEDGE 0