BLUESTEM HEALTH: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BLUESTEM HEALTH (EIN 41-2056863)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-07
IRS object ID
201321279349300047
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)
Timestamp2013-05-07T11:51:01-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN476097913EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SEIM JOHNSON LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line118081 BURT STREET SUITE 200AddressLine1
CityOMAHACity
StateNEState
ZIP Code680224722ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN412056863EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PEOPLE'S HEALTH CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPEOPNameControl
Phone4024761640Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11021 NORTH 27TH STREETAddressLine1
CityLINCOLNCity
StateNEState
ZIP Code68503ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGRETCHEN THORNBURGName
TitleINTERIM EXECUTIVE DIRECTORTitle
Phone4024761640Phone
Date Signed2013-05-03DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJULIE M GERKENName
PTINP00400882PTIN
Phone4023302660Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGRETCHEN THORNBURGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11021 NORTH 27TH STREETAddressLine1
CityLINCOLNCity
StateNEState
ZIP Code68503ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5718543GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.PHCLINCOLN.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2002YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionCOMMUNITY HEALTH SERVICES PROVIDE AFFORDABLE, COMPREHENSIVE, ACCESSIBLE, CULTURALLY APPROPRIATE, COST EFFECTIVE HEALTH AND DENTAL CARE TO INDIVIDUALS AND FAMILIES WITH LIMITED RESOURCES AND/OR OTHER BARRIERS TO SERVICE.ActivityOrMissionDescription
Nbr Voting Members Governing Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members22NbrIndependentVotingMembers
Total Nbr Employees111TotalNbrEmployees
Total Nbr Volunteers40TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2173858ContributionsGrantsPriorYear
Contributions Grants Current Year2541318ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3041055ProgramServiceRevenuePriorYear
Program Service Revenue CY3172327ProgramServiceRevenueCY
Investment Income Prior Year-1023InvestmentIncomePriorYear
Investment Income Current Year74InvestmentIncomeCurrentYear
Other Revenue Prior Year1321OtherRevenuePriorYear
Other Revenue Current Year3910OtherRevenueCurrentYear
Total Revenue Prior Year5215211TotalRevenuePriorYear
Total Revenue Current Year5717629TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2934229SalariesEtcPriorYear
Salaries Etc Current Year3413851SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1864747OtherExpensePriorYear
Other Expenses Current Year1831431OtherExpensesCurrentYear
Total Expenses Prior Year4798976TotalExpensesPriorYear
Total Expenses Current Year5245282TotalExpensesCurrentYear
Revenues Less Expenses Prior Year416235RevenuesLessExpensesPriorYear
Revenues Less Expenses CY472347RevenuesLessExpensesCY
Total Assets BOY2900909TotalAssetsBOY
Total Assets EOY3283271TotalAssetsEOY
Total Liabilities BOY473782TotalLiabilitiesBOY
Total Liabilities EOY383797TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2427127NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2899474NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE PEOPLE'S HEALTH CENTER PROVIDES AFFORDABLE, COMPREHENSIVE, ACCESSIBLE, CULTURALLY APPROPRIATE, COST EFFECTIVE PRIMARY HEALTH CARE. THE CENTER WILL SERVE PEOPLE OF THE LINCOLN, NEBRASKA AREA, ESPECIALLY THOSE INDIVIDUALS/FAMILIES WITH LIMITED RESOURCES OR WITH OTHER BARRIERS TO HEALTH CARE TO IMPROVE THEIR OVERALL HEALTH.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2166229Expense
Revenue1838757Revenue
DescriptionMEDICAL SERVICES - PHC PROVIDES COMPREHENSIVE MEDICAL SERVICES TO ITS PATIENTS. OUR PROVIDER STAFF INCLUDES FAMILY PRACTICE PHYSICIANS, NURSE PRACTITIONERS, A PHYSICIAN ASSISTANT, CERTIFIED NURSE MIDWIVES (PROVIDE OB CARE/DELIVERIES) AND VOLUNTEER SPECIALTY PHYSICIANS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense620493Expense
Revenue526692Revenue
DescriptionDENTAL SERVICES - PHC OFFERS PREVENTATIVE DENTAL SERVICES INCLUDING: X-RAYS, EXAMS, CLEANINGS, FILLINGS AND EXTRACTIONS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense304021Expense
Revenue258062Revenue
DescriptionINTEGRATED BEHAVIORAL HEALTH - INTEGRATED BEHAVIORAL HEALTH IS OFFERED AS A JOINT EFFORT BETWEEN PEOPLE'S HEALTH CENTER, CENTERPOINTE, REGION V SERVICES NETWORK PROVIDERS AND THE COMMUNITY HEALTH ENDOWMENT. THIS PROGRAM IS DESIGNED TO OFFER ASSESSMENT, SHORT-TERM SOLUTION FOCUSED TREATMENT AND REFERRAL IN A COST-EFFECTIVE, EFFICIENT MODEL. DESIRED OUTCOMES INCLUDE LESS FREQUENT NEED FOR MEDICAL CARE, FEWER SOMATIC HEALTH SYMPTOMS, INCREASED MEDICATION COMPLIANCE FOR INDIVIDUALS WITH CHRONIC ILLNESSES, DECREASED ANXIETY, REFERRALS FOR PATIENTS EXPERIENCING ISSUES WITH ALCOHOL AND OTHER DRUG RELATED PROBLEMS, AND MORE PATIENTS RECEIVING SERVICES AT PEOPLE'S HEALTH CENTER DUE TO A REDUCTION IN THE AMOUNT OF TIME PRIMARY HEALTH CARE PROVIDERS ARE NEEDED TO SPEND WITH BEHAVIORAL HEALTH PATIENTS.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense732578Expense
Revenue548816Revenue
DescriptionOTHER SERVICES - COMMUNITY SERVICES, MEDICAL RECORDS, LAB, X-RAY, PHARMACYDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp732578TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev548816TotalOfOtherProgramServiceRev
Total Program Service Expense3823321TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109621NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees111NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members22NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1GRETCHEN THORNBURG FINANCE DIRECTORBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4024761640TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11021 N 27TH STREETAddressLine1
CityLINCOLNCity
StateNEState
ZIP Code68503ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
JANET COLEMAN
CHAIR4.00XX000
PAULA GUERRERO
SECRETARY2.00XX000
PAT MEYER
TREASURER2.00XX000
KEVIN FLORES
VICE CHAIR2.00XX000
SUSANNE BLUE
PAST CHAIR2.00XX000
JOAN ANDERSON
DIRECTOR1.00X000
KATHLEEN CAMPBELL
DIRECTOR1.00X000
WAYNE CRAMM
DIRECTOR1.00X000
KELLY EPP
DIRECTOR1.00X000
RYAN GRATOPP
DIRECTOR1.00X000
DEBBIE HOUSER
DIRECTOR1.00X000
JILL JENSEN
DIRECTOR1.00X000
DANAY KALKOWSKI
DIRECTOR1.00X000
JENNIE LESOING-LUCS
DIRECTOR1.00X000
LINDA MANGAN
DIRECTOR1.00X000
DEB OMAN
DIRECTOR1.00X000
JOYCE SCHMECKLE
DIRECTOR1.00X000
EMMETT SNOW
DIRECTOR1.00X000
KK TRIVEDI
DIRECTOR1.00X000
MOHAMMED TUMA
DIRECTOR1.00X000
SHAREON TURNER
DIRECTOR1.00X000
VERONICA YUNGE
DIRECTOR1.00X000
GRETCHEN THORNBURG
INTERIM EXECUTIVE DIRECTOR40.00X62441011435
DEBRA SHOEMAKER
EXECUTIVE DIRECTOR40.00X92000011473
DR ARATHI REDDY
DENTAL DIRECTOR32.0012703605081X
DR ALBERT HALLS
PHYSICIAN40.00137777027371X
DR DAVID PAULUS
CHIEF MEDICAL OFFICER40.00157511028814X
DR MARYAM MAHMOODIAN
MEDICAL DIRECTOR40.0011937506212X
FieldValueIRS element (for citing)
Total Reportable Comp From Org696140TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation90386TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants1803387GovernmentGrants
All Other Contributions737931AllOtherContributions
Noncash Contributions86021NoncashContributions
Total Contributions2541318TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICAID62140016747011674701
PATIENT FEES621400942316942316
MEDICARE621400358958358958
CASE MANAGEMENT FEES621400125998125998
PHARMACY6214007035470354
FieldValueIRS element (for citing)
Total Program Service Revenue3172327TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column988TotalRevenueColumn
Exclusion$988ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other914Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-914Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-914TotalRevenueColumn
Exclusion-$914ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column3910TotalRevenueColumn
Exclusion$3,910ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue3910TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column5717629TotalRevenueColumn
Related Or Exempt Function Income3172327RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,984ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total177349Total
Management And General177349ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2582899Total
Program Services1882755ProgramServices
Management And General700144ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total50973Total
Program Services44784ProgramServices
Management And General6189ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total367795Total
Program Services219570ProgramServices
Management And General148225ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total234835Total
Program Services156861ProgramServices
Management And General77974ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total45577Total
Program Services265ProgramServices
Management And General45312ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total38578Total
Management And General38578ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total668991Total
Program Services600013ProgramServices
Management And General68978ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total10026Total
Management And General10026ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total407417Total
Program Services332880ProgramServices
Management And General74537ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total221607Total
Program Services215899ProgramServices
Management And General5708ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total26719Total
Program Services12988ProgramServices
Management And General13731ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total830Total
Management And General830ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1609Total
Management And General1609ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total171067Total
Program Services156387ProgramServices
Management And General14680ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total33636Total
Program Services22284ProgramServices
Management And General11352ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE159251159251
LICENSES, FEES & MEMBER432301913924091
MISCELLANEOUS EXPENSES28932452648

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5245282Total
Program Services3823321ProgramServices
Management And General1421961ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY750BOY
EOY1000EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1006655BOY
EOY1510791EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY147410BOY
EOY154620EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY418354BOY
EOY359676EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3625BOY
EOY2383EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2119374LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec864573LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1324115BOY
EOY1254801EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2900909BOY
EOY3283271EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY228478BOY
EOY209441EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY65304BOY
EOY34356EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY180000BOY
EOY140000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY473782BOY
EOY383797EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2427127BOY
EOY2899474EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2427127BOY
EOY2899474EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2900909BOY
EOY3283271EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses472347ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1556666CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1914467CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2113180CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2173858CurrentTaxYearMinus1Year
Current Tax Year2455297CurrentTaxYear
Total10213468Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1556666CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1914467CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2113180CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2173858CurrentTaxYearMinus1Year
Current Tax Year2455297CurrentTaxYear
Total10213468Total
FieldValueIRS element (for citing)
Public Support Total17010213468PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5849CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1340CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years323CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year201CurrentTaxYearMinus1Year
Current Tax Year988CurrentTaxYear
Total8701Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2205099CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2665938CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3290867CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3042376CurrentTaxYearMinus1Year
Current Tax Year3176237CurrentTaxYear
Total14380517Total
FieldValueIRS element (for citing)
Total Support24602686TotalSupport
Public Support Pertcentage1700.41510PublicSupportPertcentage170
Public Support Pertcent Prior Year0.40360PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1092715OtherCostOrOtherBasis
Depreciation334373Depreciation
Book Value758342BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1026659OtherCostOrOtherBasis
Depreciation530200Depreciation
Book Value496459BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1254801TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt5776885TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities59256DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F99059256RevenueNotRptdF990
Revenue Subtotal5717629RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9905717629TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5304538TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities59256DonatedServicesUseOfFacilities
Expenses Not Rptd F99059256ExpensesNotRptdF990
Expenses Subtotal5245282ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9905245282TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHE HEALTH CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HEALTH CENTER ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE HEALTH CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2012 AND 2011, THE HEALTH CENTER HAD NO UNCERTAIN TAX POSITIONS. WITH FEW EXCEPTIONS, THE HEALTH CENTER IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2008.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DR ALBERT HALLS
PHYSICIAN1377770000059070214640165148000
DR DAVID PAULUS
CHIEF MEDICAL OFFICER1575110000068960219180186325000

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions300NumberOfContributions
Noncash Contribs Rptd F99086021NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE FINANCE COMMITTEE REVIEWS THE FORM 990 AND PRESENTS IT TO THE BOARD OF DIRECTORS WITH A RECOMMENDATION FOR APPROVAL BEFORE IT IS SUBMITTED.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY RESPONSIBLE PERSONS AND EACH RESPONSIBLE PERSON MUST ANNUALLY COMPLETE A DISCLOSURE FORM IDENTIFYING ANY POSSIBLE CONFLICTS OF INTEREST. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWD AND UPDATED AT THE ANNUAL MEETING EACH YEAR.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS OF PEOPLE'S HEALTH CENTER SETS THE COMPENSATION FOR THE EXECUTIVE DIRECTOR AND OTHER KEY EMPLOYEES. THEY REVIEW AN ANNUAL SALARY SURVEY CONDUCTED BY THE IOWA/NEBRASKA PRIMARY CARE ASSOCIATION, WHICH IS A SALARY RANGE SURVEY COMPLETED BY EIGHTEEN COMMUNITY HEALTH CENTERS. THE BOARD ALSO REVIEWS THE SALARY SURVEY FOR NONPROFIT ORGANIZATIONS IN THE SURROUNDING AREAS PRODUCED BY THE NONPROFIT ASSOCIATION OF THE MIDLANDS. DECISIONS FOR COMPENSATION ARE BASED ON A PERSON'S EXPERIENCE, SKILLS AND EDUCATIONAL LEVEL. THE SALARIES ARE APPROVED WITH A MAJORITY VOTE OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19THE PEOPLE'S HEALTH CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2C:THE BOARD OF DIRECTORS OF PEOPLE'S HEALTH CENTER ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.