2013-09-10T09:17:55-05:00 2013-01-31 390758449 WIPFLI LLP 43A W DAVENPORT ST RHINELANDER WI 54501 990 2012-02-01 391550213 NORTHERN HEALTH CENTERS INC NORT 7152766321 PO BOX 179 LAKEWOOD WI 54138 MICHELLE WHITE 7152766321 2013-09-10 1 RANDALL H BEARD CPA P00023289 7153691040 2013-09-09 2012 2016-02-24 21:20:13Z MICHELLE WHITE PO BOX 179 LAKEWOOD WI 54138 3591223 0 X WWW.NHCMEDDEN.COM X 1986 WI TO IMPROVE OUR COMMUNITY HEALTH BY PROVIDING ALL PERSONS A COMPREHENSIVE PROGRAM OF QUALITY FAMILY ORIENTED PRIMARY HEALTH CARE SERVICES REGARDLESS OF ABILITY TO PAY. 10 10 59 15 0 0 770457 794542 2860208 2785143 0 0 8820 8709 3639485 3588394 0 0 0 0 2300923 2698320 0 0 0 1239879 1113333 3540802 3811653 98683 -223259 2646157 2546947 793784 917833 1852373 1629114 TO IMPROVE OUR COMMUNITY HEALTH BY PROVIDING ALL PERSONS A COMPREHENSIVE PROGRAM OF QUALITY FAMILY ORIENTED PRIMARY HEALTH CARE SERVICES REGARDLESS OF THEIR ABILITY TO PAY. 0 0 2752007 2751654 NORTHERN HEALTH CENTERS, INC. IS A FEDERALLY QUALIFIED HEALTH CENTER LOCATED IN NORTHEAST WISCONSIN. WE ARE A COMMUNITY HEALTH CENTER SERVING A MEDICALLY UNDERSERVED POPULATION WITHIN A FIVE COUNTY RADIUS. THE SERVICES PROVIDED TO OUR PATIENT POPULATION ARE MEDICAL, DENTAL, BEHAVIORAL HEALTH CARE AND ENABLING SERVICES. NHC CONTINUES TO PROVIDE PREVENTIVE DENTAL SERVICES TO THE UNDERSERVED CHILDREN THROUGH OUR SEAL-A-SMILE PROGRAM WHICH WAS IMPLEMENTED IN 2010; WE HAVE INCREASED THE NUMBER OF SCHOOLS WE PROVIDE SEALANTS TO FROM 15 TO 24 SCHOOLS IN THREE COUNTIES. 2752007 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 46 0 59 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X MICHELLE WHITE 7152766321 15397 HWY 32 LAKEWOOD WI 54138 TED BARTELS 1.00 X 0 0 0 BETTY MACINTOSH 1.00 X 0 0 0 GARY DONALDSON 1.00 X 0 0 0 BETH HARTMAN 1.00 X X 0 0 0 MIKE HESS 1.00 X 0 0 0 DEBBIE KRUGER 1.00 X X 0 0 0 CHRIS BERRY 1.00 X 0 0 0 PAAL HANSEN 1.00 X X 0 0 0 GAIL NELSON 1.00 X 0 0 0 DICK KENDALL 1.00 X 0 0 0 ANN KROLL 1.00 X 0 0 0 MICHELLE WHITE 41.00 X 77724 0 4059 TED JUNG 40.00 X 167962 0 12606 LANCE ORLINSKI 40.00 X 112271 0 4059 STEPHANIE REIMER 40.00 X 154671 0 4059 PEGGEY CHRISTIANSON 40.00 X 118983 0 5712 631611 0 30495 4 0 1 0 WPS INSURANCE 1717 W BROADWAY MADISON WI 53708 HEALTH INSURANCE FOR EMPLOYEES 167974 1 790542 4000 794542 MEDICAL & DENTAL SERVI 621110 1538638 1538638 FQHC REIMBURSEMENTS 621110 1213016 1213016 NURSING REVENUE 621110 33489 33489 2785143 11538 2829 8709 8709 3588394 2785143 0 8709 2267184 1656048 611136 431136 289741 141395 52383 5994 46389 266900 230196 36704 34749 34749 40238 4566 35672 25119 22607 2512 34938 14326 20612 20935 20935 118440 106596 11844 20167 20167 MEDICAL & DENTAL SUPPLI 205300 205300 BAD DEBT EXPENSE 79730 79730 REPAIRS AND MAINTENANCE 70527 70392 135 SMALL EQUIPMENT PURCHAS 56752 7537 49215 87155 58974 28181 3811653 2752007 1059646 0 52420 84060 5337 5352 645580 456915 277814 352229 56012 43318 21788 32879 2568691 1000147 1544821 1568544 42385 3650 2646157 2546947 133187 193082 643940 713804 16657 10947 793784 917833 X 1852373 1629114 1852373 1629114 2646157 2546947 -223259 0 X 0 0 0 X 622584 1028394 1168946 768802 749909 4338635 622584 1028394 1168946 768802 749909 4338635 4338635 3422 3883 502 403 311 8521 5203 10613 43396 10065 8709 77986 4425142 11382899 0.98050 0.98200 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 84293 84293 861149 320692 540457 659355 71928 587427 963894 607527 356367 1568544 CAPITAL LEASE OBLIGATIONS 10947 10947 X 3588394 0 3588394 0 3588394 3811653 0 3811653 0 3811653 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION IS A NON-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM STATE INCOME TAXES. THE ORGANIZATION ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OR THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. FEDERAL RETURNS FOR THE YEARS ENDED 2008 AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS. X 0 0 0 0 0 0 0 0 0 TED JUNG 146250 0 2000 0 19712 0 3369 0 9237 0 180568 0 0 0 STEPHANIE REIMER 123116 0 27700 0 3855 0 0 0 4059 0 158730 0 0 0 GARY DONALDSON NICOLET PHARMACY BOARD OF DIRECTOR 340B PHARMACY 0 FORM 990, PART VI, SECTION B, LINE 11 A COPY WAS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. THE AUDITING FIRM ALSO PRESENTED COMPREHENSIVE AUDIT INFORMATION DIRECTLY TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C BOTH STAFF AND BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT IDENTIFYING ANY CONFLICTS ON AN ANNUAL BASIS. STAFF HAS RECEIVED REQUIRED TRAINING ON THE POLICY AND IT IS MONITORED ON A MONTHLY BASIS. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST AND ADDRESSING ANY ISSUES AS A RESULT OF THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY PERFORMANCE COUPLED WITH PREVAILING INDUSTRY STANDARDS AND THE CURRENT NACHC COMPENSATION REPORT. FORM 990, PART VI, SECTION C, LINE 19 ALL STAFF AND BOARD OF DIRECTORS MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. STAFF RECEIVES REQUIRED TRAINING UPON HIRE AND AT LEAST ANNUALLY THEREAFTER. THERE ARE ESTABLISHED POLICIES FOR REPORTING AND RESPONDING TO VIOLATIONS OF THE CONFLICT OF INTEREST POLICY WHICH IS PART OF THE LARGER NHC CORPORATE COMPLIANT POLICY. NHCS CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST AND FOLLOWING ESTABLISHED POLICY TO ADDRESS AND REPORTS OF VIOLATIONS.