KENOSHA COMMUNITY HEALTH CENTER INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- KENOSHA COMMUNITY HEALTH CENTER INC (EIN 39-1789874)
- Tax period
- 2011-03-01 to 2012-02-29
- Filed
- 2012-08-14
- IRS object ID
- 201202279349301030
- Schema version
- 2011v1.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-14T09:41:46-05:00 | Timestamp |
| Tax Period End Date | 2012-02-29 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1347 | AddressLine1 |
| City | RACINE | City |
| State | WI | State |
| ZIP Code | 534011347 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-03-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391789874 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENOSHA COMMUNITY HEALTH CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | KENO | NameControl |
| Phone | 2626560044 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 57TH STREET SUITE 700 | AddressLine1 |
| City | KENOSHA | City |
| State | WI | State |
| ZIP Code | 53140 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID HUGHES | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 2626560044 | Phone |
| Date Signed | 2012-07-31 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KIMBERLY ANDERSON CPA | Name |
| PTIN | P00188889 | PTIN |
| Phone | 2626379351 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DAVID HUGHES | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 57TH STREET SUITE 700 | AddressLine1 |
| City | KENOSHA | City |
| State | WI | State |
| ZIP Code | 53140 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12561570 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.KENOSHACHC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 180 | TotalNbrEmployees |
| Total Nbr Volunteers | 13 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1397441 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4007947 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 6552819 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 8533323 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1461 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1029 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 14079 | OtherRevenuePriorYear |
| Other Revenue Current Year | 19271 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7965800 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12561570 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1476 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 630 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5541633 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7053326 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2312515 | OtherExpensePriorYear |
| Other Expenses Current Year | 2878898 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7855624 | TotalExpensesPriorYear |
| Total Expenses Current Year | 9932854 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 110176 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2628716 | RevenuesLessExpensesCY |
| Total Assets BOY | 7462700 | TotalAssetsBOY |
| Total Assets EOY | 10577632 | TotalAssetsEOY |
| Total Liabilities BOY | 3578411 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4064627 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3884289 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6513005 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 2476693 | Expense |
| Grants | 630 | Grants |
| Revenue | 3146099 | Revenue |
| Description | INCREASING ACCESS TO COMPREHENSIVE MEDICAL, DENTAL, AND BEHAVIORAL HEALTH CARE FOR MEDICAID ENROLLEES AND THE UNINSURED. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4756342 | Expense |
| Revenue | 5406495 | Revenue |
| Description | TO INCREASE HEALTH OUTCOMES FOR MEDICAID ENROLLEES AND THE UNINSURED. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 7233035 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 7 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 180 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID HUGHES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2627643607 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 57TH STREET SUITE 700 | AddressLine1 |
| City | KENOSHA | City |
| State | WI | State |
| ZIP Code | 53140 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| FRANK LUDOWISE | |||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| WILLIAM ROBERTS | |||||||
| PRESIDENT | 1.00 | X | X | 0 | 0 | 0 | |
| JACKIE BUSH | |||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | |
| CINDY JOHNSON | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JO A WYNN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| PAM HALBACH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| LATASHA JONES | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JAY A CASHMORE | |||||||
| VICE PRESIDENT | 1.00 | X | X | 0 | 0 | 0 | |
| LORETTE MITCHELL | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| SHEBANIAH MUHAMAD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DANIEL HEYDEN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JACK WATERS | |||||||
| EXECUTIVE DIRECTOR | 40.00 | X | 129494 | 0 | 6160 | ||
| BETH RUHLAND | |||||||
| CHIEF OPERATING OFFICER | 40.00 | X | 115270 | 0 | 4600 | ||
| DAVID HUGHES | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | X | 172204 | 0 | 9857 | ||
| ALESSANDRO SAVAGLIO JR | |||||||
| DENTIST | 40.00 | 215122 | 0 | 8588 | X | ||
| PRZEMYSLAW KOLANKO | |||||||
| PHYSICIAN | 40.00 | 152043 | 0 | 13361 | X | ||
| ELZBIETA KOSLACZ-KOLANKO | |||||||
| PHYSICIAN | 40.00 | 118358 | 0 | 6157 | X | ||
| THOMAS JAZWIECKI | |||||||
| DENTIST | 40.00 | 150181 | 0 | 6805 | X | ||
| UMAIR SHARIH | |||||||
| PHYSICIAN | 40.00 | 168561 | 0 | 11488 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1221233 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 67016 | TotalOtherCompensation |
| Number Individuals GT100 K | 12 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Government Grants | 3971548 | GovernmentGrants |
| All Other Contributions | 36399 | AllOtherContributions |
| Total Contributions | 4007947 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE FEES | 621110 | 8346842 | 8346842 |
| MEDICARE EHR INCENTIVE | 900099 | 106250 | 106250 |
| CONSULTING REVENUE | 621110 | 80231 | 80231 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 8533323 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1029 | TotalRevenueColumn |
| Exclusion | $1,029 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 19271 | TotalRevenueColumn |
| Related Or Exempt Function Income | 19271 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 19271 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12561570 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8552594 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,029 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 630 | Total |
| Program Services | 630 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 433048 | Total |
| Program Services | 320456 | ProgramServices |
| Management And General | 112592 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5404068 | Total |
| Program Services | 3999705 | ProgramServices |
| Management And General | 1404363 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 108379 | Total |
| Program Services | 78245 | ProgramServices |
| Management And General | 30134 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 616688 | Total |
| Program Services | 432252 | ProgramServices |
| Management And General | 184436 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 491143 | Total |
| Program Services | 353707 | ProgramServices |
| Management And General | 137436 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30222 | Total |
| Program Services | 28817 | ProgramServices |
| Management And General | 1405 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28331 | Total |
| Program Services | 3115 | ProgramServices |
| Management And General | 25216 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 638780 | Total |
| Program Services | 367049 | ProgramServices |
| Management And General | 271731 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25012 | Total |
| Program Services | 17597 | ProgramServices |
| Management And General | 7415 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75585 | Total |
| Program Services | 56816 | ProgramServices |
| Management And General | 18769 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 283394 | Total |
| Program Services | 177065 | ProgramServices |
| Management And General | 106329 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53977 | Total |
| Program Services | 10398 | ProgramServices |
| Management And General | 43579 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23198 | Total |
| Program Services | 7347 | ProgramServices |
| Management And General | 15851 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 145200 | Total |
| Management And General | 145200 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 363629 | Total |
| Program Services | 317005 | ProgramServices |
| Management And General | 46624 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31807 | Total |
| Program Services | 23851 | ProgramServices |
| Management And General | 7956 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 508151 | 491133 | 17018 |
| REPAIRS AND MAINTENANCE | 158208 | 113342 | 44866 |
| SMALL EQUIPMENT | 145467 | 117783 | 27684 |
| RECRUITMENT AND STAFF T | 120644 | 93979 | 26665 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 247293 | Total |
| Program Services | 222743 | ProgramServices |
| Management And General | 24550 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9932854 | Total |
| Program Services | 7233035 | ProgramServices |
| Management And General | 2699819 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16327 | BOY |
| EOY | 704741 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 976920 | BOY |
| EOY | 164259 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 95942 | BOY |
| EOY | 296000 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1381533 | BOY |
| EOY | 2009635 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 95712 | BOY |
| EOY | 233396 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8534262 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1364661 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4896266 | BOY |
| EOY | 7169601 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7462700 | BOY |
| EOY | 10577632 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 562263 | BOY |
| EOY | 1055691 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16148 | BOY |
| EOY | 8936 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3000000 | BOY |
| EOY | 3000000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3578411 | BOY |
| EOY | 4064627 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3884289 | BOY |
| EOY | 6513005 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3884289 | BOY |
| EOY | 6513005 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7462700 | BOY |
| EOY | 10577632 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 2628716 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 159200 | OtherCostOrOtherBasis |
| Book Value | 159200 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3690002 | OtherCostOrOtherBasis |
| Depreciation | 389233 | Depreciation |
| Book Value | 3300769 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 737854 | OtherCostOrOtherBasis |
| Depreciation | 195764 | Depreciation |
| Book Value | 542090 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1112728 | OtherCostOrOtherBasis |
| Depreciation | 651104 | Depreciation |
| Book Value | 461624 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2834478 | OtherCostOrOtherBasis |
| Depreciation | 128560 | Depreciation |
| Book Value | 2705918 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7169601 | TotalOfBookValueLandBuildings |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID HUGHES | |||||||||||||
| 103654 | 0 | 64430 | 0 | 4120 | 0 | 6857 | 0 | 3000 | 0 | 182061 | 0 | 0 | 0 |
| ALESSANDRO SAVAGLIO JR | |||||||||||||
| 168270 | 0 | 39708 | 0 | 7144 | 0 | 8588 | 0 | 0 | 0 | 223710 | 0 | 0 | 0 |
| PRZEMYSLAW KOLANKO | |||||||||||||
| 136988 | 0 | 0 | 0 | 15055 | 0 | 6075 | 0 | 7286 | 0 | 165404 | 0 | 0 | 0 |
| THOMAS JAZWIECKI | |||||||||||||
| 127552 | 0 | 16708 | 0 | 5921 | 0 | 6003 | 0 | 802 | 0 | 156986 | 0 | 0 | 0 |
| UMAIR SHARIH | |||||||||||||
| 146770 | 0 | 13151 | 0 | 8640 | 0 | 6736 | 0 | 4752 | 0 | 180049 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 4B | ReturnReference |
| Explanation | DAVID HUGHES - $6,857 THOMAS JAZWIECKI - $6,003 PRZEMYSLAW KOLANKO - $6,075 ELZBIETA KOSLACZ-KOLANKO - $5,014 BETH RUHLAND - $4,600 ALESSANDRO SAVAGLIO JR. - $8,588 UMAIR SHARIH - $6,736 JOHN WATERS - $5,160 | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| 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. |
| 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 | UPON REQUEST |
| FORM 990, PART XI, LINE 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENOSHA COMMUNITY HEALTH CENTER LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4536 22ND AVENUE | AddressLine1 |
| City | KENOSHA | City |
| State | WI | State |
| ZIP Code | 53140 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391789874 | EIN |
| Primary Activities | REAL ESTATE HOLDING | PrimaryActivities |
| Legal Domicile State | WI | LegalDomicileState |
| Total Income | -4752 | TotalIncome |
| EOY Assets | 3459971 | EOYAssets |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |