2013-11-11T15:38:51-06:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2012-01-01 043634356 BOUNDARY REGIONAL HEALTH CENTER INC BOUN 2082678422 30410 HIGHWAY 200 PONDERAY ID 83852 VICTORIA MCCLELLAN KING CEO 2082678422 2013-11-08 1 DANIEL M FREIN P00856532 4252506100 2013-11-08 2012 2016-03-07 17:11:31Z X KANIKSU HEALTH SERVICE VICTORIA MCCLELLAN KING 30410 HIGHWAY 200 PONDERAY ID 83852 5821536 0 X N/A X 2002 ID THE MISSION OF KANKSU HEALTH SERVICES IS TO PROVIDE HIGH QUALITY, COST EFFECTIVE, CULTURALLY SENSITIVE HEALTH CARE SERVICES. 9 9 103 9 0 0 2441291 1718254 3247881 4103282 0 0 0 0 5689172 5821536 0 0 0 0 3801786 4407170 0 0 0 1514734 1556046 5316520 5963216 372652 -141680 2761411 2770913 2337821 2489003 423590 281910 THE MISSION OF KANIKSU HEALTH SERVICES IS TO PROVIDE HIGH QUALITY, COST EFFECTIVE, CULTURALLY SENSITIVE HEALTH CARE SERVICES. 0 0 5030808 3973133 KANIKSU HEALTH SERVICES (CENTER) PROVIDED MEDICAL VISITS AND DENTAL VISITS TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED MEDICAL OR DENTAL ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 5030808 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 11 0 1 103 1 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X THE ORGANIZATION 2082678422 30410 HIGHWAY 200 PONDERAY ID 83852 STEVE FOORD 2.00 X 0 0 0 KRIS TAYLOR 2.00 X 0 0 0 SUSAN EDWARDS 2.00 X 0 0 0 STEPHEN ACKER 2.00 X 0 0 0 RAY MILLER 2.00 X 0 0 0 SHEILA FARMINAUMICK 2.00 X 0 0 0 MARY READER 2.00 X 0 0 0 ERIN DELUDE 2.00 X 0 0 0 JOE ENGLISH 2.00 X 0 0 0 VICTORIA MCCLELLAN KING 40.00 X 100048 0 6529 KEVIN KNEPPER 40.00 X 82598 0 6517 TOM LAWRENCE MD 40.00 X 189119 0 7030 WARD LEEDY 40.00 X 204090 0 7030 JAMIE HETTICK 40.00 X 162240 0 6529 JEFFERY FOWLER 40.00 X 157015 0 6780 STEVEN PUFFER 40.00 X 140332 0 6780 1035442 0 47195 6 0 1 0 0 1718254 1718254 PATIENT SERVICE REVENU 621110 3973133 3973133 MISCELLANEOUS 561499 130149 130149 4103282 5821536 3973133 0 130149 402005 364251 37754 3276183 2972283 303900 39394 34326 5068 363384 325229 38155 326204 291953 34251 57953 32628 25325 2335 1643 692 15098 10621 4477 274328 192975 81353 199840 133031 66809 337775 165510 172265 71313 34943 36370 67614 33131 34483 15129 12847 2282 SUPPLIES AND POSTAGE 180526 176942 3584 BAD DEBT 124214 124214 MISC 104431 51171 53260 EQUIPMENT MAINTENANCE A 51643 48468 3175 53847 24642 29205 5963216 5030808 932408 0 75342 101484 557420 455921 6604 30392 2651352 468236 2122045 2183116 2761411 2770913 829660 1042806 1508161 1446197 2337821 2489003 X 423590 281910 423590 281910 2761411 2770913 -141680 0 X X 0 1 X 1 1 1 X 1455776 1509963 1702521 2441291 1718254 8827805 1455776 1509963 1702521 2441291 1718254 8827805 8827805 8827805 1.00000 1.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 266881 266881 1708242 66447 1641795 581166 388949 192217 95063 12840 82223 2183116 X 5821536 0 5821536 0 5821536 5963216 0 5963216 0 5963216 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CENTER HAS RECEIVED A DETERMINATION LETTER FROM THE IRS THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE CENTERS TAX POSITIONS AND CONCLUDED THAT THE CENTER HAD TAKEN NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. THE CENTER IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2009. X X X 0 0 0 0 0 0 0 0 0 TOM LAWRENCE MD 189119 0 0 0 0 0 0 0 7030 0 196149 0 5594 0 WARD LEEDY 204090 0 0 0 0 0 0 0 7030 0 211120 0 5580 0 JAMIE HETTICK 162240 0 0 0 0 0 0 0 6529 0 168769 0 0 0 JEFFERY FOWLER 157015 0 0 0 0 0 0 0 6780 0 163795 0 4710 0 FORM 990, PART VI, SECTION B, LINE 11 THE CFO WILL REVIEW A DRAFT COPY OF THE IRS FROM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICTS OF INTEREST ARE REVIEWED ANNUALLY FOR THE BOARD OF DIRECTORS AND ANNUALLY AT CONTRACT RENEWAL FOR KEY EMPLOYEEES. FORM 990, PART VI, SECTION B, LINE 15 THE KANIKSU HEALTH SERVICES COMPENSATI0N MODEL - AS APPROVED BY THE BOARD OF DIRECTORS (BOD) - IS A COMPENSATION SCHEDULE BASED ON THE MOST RECENT NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTER (NACHC) REGION 10 (WASHINGTON, OREGON, IDAHO) COMPENSATION SURVEY BASED ON SIZE OF THE ORGANIZATION - ANNUAL REVENUES, SCOPE OF RESPONSIBILITY, YEARS OF EXPERIENCE AND EDUCATIONAL DEGREES, CERTIFICATIONS, ETC. ALL JOB CATEGORIES (INCLUDING CEO, OTHER OFFICERS AND KEY EMPLOYEES, ALL CLINICAL PROVIDERS AND ALL STAFF) HAVE AN ASSOCIATED COMPENSATION MODEL - THIS APPROACH HAS BEEN APPROVED BY THE BOD. THIS IS USED FOR ALL NEW HIRES AND IS EVALUATED ANNUALLY TO BE SURE THAT THERE IS INTERNAL EQUITY AMONG EMPLOYEES, ETC. THIS COMPENSATION MODEL IS ADJUSTED ANNUALLY BASED ON THE MOST RECENT NACHC DATA - RANGES OF SALARY ARE REVIEWED. IT IS THE GOAL OF KHS TO BE IN THE MEDIAN RANGE OF THE COMPENSATION MODEL - THIS APPROACH HAS BEEN APPROVED BY THE BOD. ANY ADJUSTMENTS MADE TO CURRENT EMPLOYEES WILL BE BASED ON AVAILABILITY OF BUDGET AS APPROVED BY THE BOD AND WILL BE DETERMINED BY "RANGE MOVEMENT" FOR STAFF POSITIONS AND FOR MAINTAINING COMPETITIVE RECRUITMENT AND RETENTION FOR PROVIDERS AS COMPARED TO THE OTHER COMMUNITY HEALTH CENTERS IN IDAHO AND IN REGION 10. DECISIONS ARE MADE BY THOSE WITHOUT CONFLICT AND THE DECISIONS ARE DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE CENTER DOES NOT MAKE THE GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. AS A RESULT OF A FEDERAL AWARD, THE ORGANIZATION IS REQUIRED TO UNDERGO AN AUDIT AS REQUIRED BY THE SINGLE AUDIT ACT. THE CENTER'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE FEDERAL AUDIT CLEARINGHOUSE WEBSITE. FORM 990, PART XII, LINE 2C: THE OVERSIGHT PROCESS AND METHOD FOR SELECTING THE INDEPENDENT AUDITOR HAS NOT CHANGED FROM PRIOR YEARS. FORM 990, PART XII, LINE 3B: THE CENTER IS SUBJECT TO THE PROVISIONS OF THE SINGLE AUDIT ACT AS A RESULT OF A FEDERAL AWARD. AS SUCH, THE CENTER IS REQUIRED TO UNDERGO AN AUDIT AS REQUIRED BY THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. THE SINGLE AUDIT HAS BEEN COMPLETED FOR THE REPORTING YEAR.