SOUTHSIDE COMMUNITY HEALTH SERVICES INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHSIDE COMMUNITY HEALTH SERVICES INC (EIN 23-7113799)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-08-15
- IRS object ID
- 201202289349301650
- 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 | 2012-08-15T09:55:19-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | 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 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237113799 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHSIDE COMMUNITY HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SOUT | NameControl |
| Phone | 6128223282 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4243 FOURTH AVENUE SOUTH | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55409 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM TENDLE | Name |
| Title | EXECUTIVE DIRECTOR/CEO | Title |
| Phone | 6128223282 | Phone |
| Date Signed | 2012-08-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KOREY L BOELTER | Name |
| PTIN | P00775161 | PTIN |
| Phone | 6123764500 | 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 | WILLIAM TENDLE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4243 FOURTH AVENUE SOUTH | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55409 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5652830 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SOUTHSIDECHS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1971 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HIGH QUALITY HEALTH CARE IN THE COMMUNITIES SERVED. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 112 | TotalNbrEmployees |
| Total Nbr Volunteers | 10 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2351170 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2154313 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4208792 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3494129 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4032 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1911 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1557 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2477 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6565551 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5652830 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4817729 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 3854394 | 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 | 2274193 | OtherExpensePriorYear |
| Other Expenses Current Year | 1997720 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7091922 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5852114 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -526371 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -199284 | RevenuesLessExpensesCY |
| Total Assets BOY | 3435459 | TotalAssetsBOY |
| Total Assets EOY | 3003326 | TotalAssetsEOY |
| Total Liabilities BOY | 1021497 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 788648 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2413962 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2214678 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SOUTHSIDE COMMUNITY HEALTH SERVICES EXISTS TO SERVE THE COMMUNITY BY OFFERING FRIENDLY SUPERIOR QUALITY AND FISCALLY RESPONSIBLE HEALTH SERVICES IN AN ENVIRONMENT THAT FOSTERS LEARNING AND RESPECT. IT DOES THIS THROUGH COLLABORATION AND COMMUNICATION WHICH PATIENTS ACCEPT AS AN OPPORTUNITY TO IMPROVE THEIR HEALTH. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 2252463 | Expense |
| Revenue | 1830383 | Revenue |
| Description | MEDICALFAMILY PRACTICE INCLUDING SPECIAL PROGRAMS FOR AT RISK POPULATIONS, FAMILY PLANNING, PRENATAL AND PEDIATRICS.SOUTHSIDE COMMUNITY HEALTH SERVICES, INC. (SCHS) IS A 501 (C) 3 NONPROFIT ORGANIZATION AND IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), LOCATED IN SOUTH MINNEAPOLIS. SCHS HAS ONE MEDICAL CLINIC IN MINNEAPOLIS, ONE MEDICAL CLINIC IN STILLWATER AND ONE DENTAL CLINIC IN MINNEAPOLIS. WHILE THE MAJORITY OF PATIENTS COME FROM THE SOUTHSIDE OF MINNEAPOLIS, SCHS DRAWS PATIENTS FROM THROUGHOUT THE TWIN CITIES METROPOLITAN AREA (PATIENTS CAME FROM OVER 110 ZIP CODES). SCHS HAS HAD AN "ESSENTIAL COMMUNITY SAFETY NET PROVIDER" DESIGNATION FROM THE STATE OF MINNESOTA SINCE 1997. SCHS DOES NOT DISCRIMINATE AGAINST ANY PATIENT BASED ON RACE, COLOR, NATIONAL ORIGIN, DISABILITY, RELIGION, SEXUAL ORIENTATION, AGE, OR ABILITY TO PAY.IN 2011, OUR CLINICS SERVED MOSTLY LOW INCOME AND UNDER-SERVED WOMEN, CHILDREN AND FAMILIES. THESE 10,309 PATIENTS GENERATED 27,033 CLINIC VISITS. IN ADDITION TO THE CLINIC VISITS, OUR OUTREACH ACTIVITIES NOW KNOWN AS Q HEALTH CONNECTIONS, REACHED ANOTHER 10,000 RESIDENTS THROUGH LOCAL HEALTH FAIRS, A VARIETY OF PROGRAMS, AND OTHER COMMUNITY EVENTS. Q HEALTH CONNECTIONS PROVIDES MUCH NEEDED HEALTH EDUCATION AND HEALTH AWARENESS TO MINORITY POPULATIONS SUFFERING DRAMATICALLY HIGHER HEALTH OUTCOME DISPARITIES.IN 2011, THE UNINSURED REPRESENTED 37.6% OF TOTAL PATIENTS. IF YOU REMOVE THE UNKNOWN OR UNREPORTED NUMBER OF PATIENTS FROM THE POVERTY LEVEL CALCULATION, THE REMAINDER WAS EVEN A HIGHER PERCENT OF POVERTY, NAMELY 74.7%. 21.2% OF PATIENTS WERE ON MEDICAID AND 2.2% WERE ON OTHER PUBLIC INSURANCE COVERAGE. 10.6% OF PATIENTS WERE PRIVATELY INSURED. THE UNINSURED WERE PLACED ON A SLIDING FEE SCHEDULE. 52.9% OF PATIENTS WERE BELOW 100% OF FEDERAL POVERTY LEVEL AND ANOTHER 8.6% OF PATIENTS WERE BETWEEN 100% AND 200% OF FEDERAL POVERTY LEVEL. AS A RESULT, 61.5% OF PATIENTS WERE CONSIDERED ECONOMICALLY DISADVANTAGED. WHEN YOU COMBINE POVERTY LEVEL, THOSE ON MEDICAID AND OTHER PUBLICALLY SUBSIDIZED INSURANCE COVERAGE AND DISCOUNTED CARE THROUGH THE SLIDING FEE SCHEDULE, THIS RESULTED IN A SIGNIFICANT SHORTFALL IN OPERATING REVENUES, NECESSITATING SOME LAYOFFS FOR A SECOND YEAR IN A ROW.IN 2011, SCHS PATIENT CASELOAD REPRESENTED 26.5% CHILDREN AND TEENS AND 74.5% WERE ADULTS. 57.9% OF PATIENTS WERE FEMALE, 42.1% WERE MALE. OF THOSE PATIENTS REPORTING RACE (6,325 OUT OF 10,309) 23.6% WERE BLACK/AFRICAN-AMERICAN; 31.0% WERE HISPANIC/LATINO, 3.4% WERE ASIAN/NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER; 0.5% WERE AMERICAN INDIAN 40.8%% WERE NON HISPANIC WHITE AND 1.2% SELF-IDENTIFIED THEMSELVES AS MORE THAN ONE RACE. IN 2011, 23.8% OF SCHS' PATIENTS WERE IMMIGRANTS, MANY WITH LIMITED ENGLISH SPEAKING ABILITIES AND LITERACY LEVELS, 32 PATIENTS WERE CLASSIFIED AS HOMELESS AND 20 PATIENTS WERE MIGRANTS/SEASONAL WORKERS.IN CONCLUSION, SCHS HAS LONG SERVED THE POOR AND HISTORICALLY DISENFRANCHISED POPULATIONS WITHIN THE COMMUNITY. AS A RESULT, A LARGE PROPORTION OF ITS REVENUE IS HIGHLY DISCOUNTED, WITH SIGNIFICANT UNCOLLECTABLE. OUR NEED TO SOLICIT OTHER INCOME FROM COMMUNITY SOURCES INCLUDING FEDERAL, STATE, MUNICIPAL AND FOUNDATIONS REFLECTS THIS REALITY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2083250 | Expense |
| Revenue | 1663746 | Revenue |
| Description | DENTALGENERAL DENTAL SERVICES FOR PEOPLE OF ALL AGES. EXPANSION WAS COMPLETED IN LATE 2009 TO ADD TWO DENTAL OPERATORIES. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 195288 | Expense |
| Description | OUTREACHFIRST KNOWN AS SOUTHSIDE COMMUNITY HEALTH SERVICES (SCHS) OUTREACH DEPARTMENT, THIS PROGRAM WAS ORIGINALLY CREATED TO CONNECT SCHS MEDICAL AND DENTAL CLINICS WITH THE UNDERSERVED AND UNINSURED POPULATIONS OF SOUTH MINNEAPOLIS.TODAY, Q HEALTH CONNECTIONS PROVIDES THE COMMUNITY WITH INNOVATIVE PROGRAMS, ACTIVITIES AND EDUCATIONAL OPPORTUNITIES DESIGNED TO IMPROVE HEALTH LITERACY AND ASSIST PEOPLE IN GETTING INVOLVED IN THEIR PERSONAL HEALTH CARE. IT HAS BEEN PROVEN THAT THE EARLIER HEALTHY PRACTICES ARE ESTABLISHED, THE BETTER THE QUALITY OF LIFE FOR THE INDIVIDUAL. THESE PRACTICES CAN INCLUDE HEALTHY DIET, CONSISTENT EXERCISE, AND ENVIRONMENTAL AND SOCIAL HEALTH | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 4531001 | 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 | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | 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 | 0 | 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 | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | 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 | 32 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 112 | 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 |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | 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 | 1 | 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 | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | PATRICIA WIDBOOM | NamePerson |
| Telephone Number | 6128212014 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4243 FOURTH AVENUE SOUTH | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55409 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JIM GALLAGHER | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| VICTOR L M GOMEZ | |||||||
| INTERIM BOARD CHAIR | 1.00 | X | 0 | 0 | 0 | ||
| LANCE HAAKENSTAD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| RITA SALONE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| YAA NTI | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| TIM RIDLEY | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| NATALIE TEJADA | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| SHEREESE MCINTOSH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| GREG BARLOW | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| MICHELLE EVANS | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM TENDLE | |||||||
| EXECUTIVE DIRECTOR/CEO | 40.00 | 126121 | 0 | 9123 | X | ||
| PATRICIA WIDBOOM | |||||||
| CFO | 40.00 | 101385 | 0 | 6337 | X | ||
| DR LEON NESVACIL | |||||||
| INTERIM MEDICAL DIRECTOR | 40.00 | 100700 | 0 | 0 | X | ||
| MARY CRACKEL | |||||||
| DENTIST | 40.00 | 102189 | 0 | 1181 | X | ||
| THOMAS R RESNICK | |||||||
| DEVELOPMENT DIRECTOR | 40.00 | 116663 | 0 | 1040 | X | ||
| DR RYAN LINDNER | |||||||
| DENTIST/DENTAL DIRECTOR | 40.00 | 120092 | 0 | 5614 | X | ||
| JANELLA FUCHS | |||||||
| CLINICAL SERVICES DIRECTOR | 40.00 | 122473 | 0 | 1051 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 789623 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 24346 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Federated Campaigns | 89781 | FederatedCampaigns |
| Government Grants | 1784151 | GovernmentGrants |
| All Other Contributions | 280381 | AllOtherContributions |
| Total Contributions | 2154313 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT FEES | 621110 | 2877573 | 2877573 |
| FQHC SETTLEMENTS | 621110 | 616556 | 616556 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3494129 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1911 | TotalRevenueColumn |
| Exclusion | $1,911 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 2477 | TotalRevenueColumn |
| Exclusion | $2,477 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2477 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5652830 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3494129 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $4,388 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 242965 | Total |
| Program Services | 85038 | ProgramServices |
| Management And General | 157927 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3063717 | Total |
| Program Services | 2441856 | ProgramServices |
| Management And General | 621861 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17323 | Total |
| Program Services | 11393 | ProgramServices |
| Management And General | 5930 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 248552 | Total |
| Program Services | 147107 | ProgramServices |
| Management And General | 101445 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 281837 | Total |
| Program Services | 215499 | ProgramServices |
| Management And General | 66338 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17443 | Total |
| Management And General | 17443 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23901 | Total |
| Management And General | 23901 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 493242 | Total |
| Program Services | 420791 | ProgramServices |
| Management And General | 72451 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52876 | Total |
| Program Services | 41526 | ProgramServices |
| Management And General | 11350 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 190123 | Total |
| Program Services | 95927 | ProgramServices |
| Management And General | 94196 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70008 | Total |
| Program Services | 34515 | ProgramServices |
| Management And General | 35493 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 244417 | Total |
| Program Services | 223618 | ProgramServices |
| Management And General | 20799 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20572 | Total |
| Program Services | 11164 | ProgramServices |
| Management And General | 9408 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5118 | Total |
| Program Services | 3688 | ProgramServices |
| Management And General | 1430 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6740 | Total |
| Management And General | 6740 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 331730 | Total |
| Program Services | 286097 | ProgramServices |
| Management And General | 45633 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35022 | Total |
| Program Services | 24111 | ProgramServices |
| Management And General | 10911 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 293354 | 286681 | 6673 |
| BAD DEBTS | 122130 | 122130 | |
| MINNESOTA PROVIDERS TAX | 54703 | 54703 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36341 | Total |
| Program Services | 25157 | ProgramServices |
| Management And General | 11184 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5852114 | Total |
| Program Services | 4531001 | ProgramServices |
| Management And General | 1321113 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43968 | BOY |
| EOY | 188376 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 569392 | BOY |
| EOY | 300957 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 505166 | BOY |
| EOY | 295748 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 304704 | BOY |
| EOY | 298861 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30510 | BOY |
| EOY | 21033 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 4071004 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2175253 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1979119 | BOY |
| EOY | 1895751 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2600 | BOY |
| EOY | 2600 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3435459 | BOY |
| EOY | 3003326 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 681497 | BOY |
| EOY | 593648 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 340000 | BOY |
| EOY | 195000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1021497 | BOY |
| EOY | 788648 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2178962 | BOY |
| EOY | 2131657 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 235000 | BOY |
| EOY | 83021 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2413962 | BOY |
| EOY | 2214678 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3435459 | BOY |
| EOY | 3003326 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -199284 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1761073 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1610936 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2474324 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2351170 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2154313 | CurrentTaxYear |
| Total | 10351816 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5771606 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4986795 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5679676 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4208792 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3494129 | CurrentTaxYear |
| Total | 24140998 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7532679 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6597731 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8154000 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6559962 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5648442 | CurrentTaxYear |
| Total | 34492814 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 34492814 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 39393 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 38628 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 23206 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4032 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1911 | CurrentTaxYear |
| Total | 107170 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 39393 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 38628 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 23206 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4032 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1911 | CurrentTaxYear |
| Total | 107170 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 86938 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 57214 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13241 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1557 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2477 | CurrentTaxYear |
| Total | 161427 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7659010 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6693573 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8190447 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6565551 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5652830 | CurrentTaxYear |
| Total | 34761411 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99230 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99240 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00310 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00310 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
| General Explanation | SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME | GeneralExplanation |
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 | 130543 | OtherCostOrOtherBasis |
| Book Value | 130543 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1406121 | OtherCostOrOtherBasis |
| Depreciation | 502272 | Depreciation |
| Book Value | 903849 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 475288 | OtherCostOrOtherBasis |
| Depreciation | 414376 | Depreciation |
| Book Value | 60912 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2059052 | OtherCostOrOtherBasis |
| Depreciation | 1258605 | Depreciation |
| Book Value | 800447 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1895751 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | LINE OF CREDIT | Description |
| Amount | $195,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 195000 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S CONSOLIDATED FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED.THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2008 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | 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 III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 5 | ReturnReference |
| Explanation | THE DEVELOPMENT DIRECTOR RECEIVES AN INCENTIVE BASED ON REVENUES. HE RECEIVES A 5% INCENTIVE ON ALL NON-GOVERNMENTAL GRANT REVENUES FOR PROGRAM SERVICES SUPPORT. HE RECEIVES A FLAT $5,000 FOR EACH GOVERNMENTAL GRANT. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE IS COMPRISED OF THE FOUR OFFICERS AND THE EXECUTIVE DIRECTOR (NON-VOTING). AT THE DISCRETION OF THE BOARD CHAIR, THE CLINICAL AND RISK MANAGEMENT CHAIRS WILL BE ON THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL ADVISE AND AID THE EXECUTIVE DIRECTOR OF THE CORPORATION IN ALL MATTERS CONCERNING THE BUSINESS AFFAIRS OF THE CORPORATION AND GENERALLY PERFORM DUTIES AND EXERCISE POWERS AS MAY BE DIRECTED OR DELEGATED BY THE BOARD OF DIRECTORS FROM TIME TO TIME. THE EXECUTIVE COMMITTEE IS ALSO CHARGED WITH THE ANNUAL EVALUATION OF THE EXECUTIVE DIRECTOR. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE CEO PROVIDED A COPY OF THE FORM 990 TO ALL BOARD MEMBERS FOR REVIEW. ALL QUESTIONS WERE ANSWERED AT A BOARD MEETING BEFORE THE 990 WAS APPROVED BY THE BOARD. THE FORM 990 WAS THEN FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE UPDATED ANNUALLY FOR ALL BOARD MEMBERS AND EMPLOYEES. ANY CONFLICT OF INTERST MUST BE IMMEDIATELY DISCLOSED TO THE EXECUTIVE DIRECTOR IN WRITING. NO MEMBER OF THE BOARD MAY VOTE ON MATTERS ON ANY AREA WHERE THEY MAY RECEIVE FINANCIAL GAIN OR WHICH MAY CONFLICT WITH MEMBERS OBLIGATIONS. | |
| FORM 990, PART VI, SECTION B, LINE 15A | THE EXECUTIVE COMMITTEE USED EXECUTIVE SALARY SURVEYS FOR COMPARABILITY PURPOSES TO UPDATE THE EXECUTIVE DIRECTOR/CEO'S COMPENSATION. THE DECISION OF THE EXECUTIVE COMMITTEE WAS ALSO REVIEWED AND APPROVED BY THE FULL BOARD OF DIRECTORS. THE PROCESS WAS CONTEMPORANEOUSLY SUBSTANTIATED. THE EXECUTIVE DIRECTOR REVIEWED AND APPROVED THE COMPENSATION FOR THE OTHER OFFICERS, USING A MARKET SURVEY CONDUCTED BY AN OUTSIDE H.R. CONSULTANT FOR COMPARABILITY PURPOSES. THE PROCESS INCLUDED COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION, BUT DID NOT INCLUDE REVIEW AND APPROVAL BY INDEPENDENT PERSONS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART VII, SECTION A | ALL MEMBERS OF THE SOUTHSIDE COMMUNITY HEALTH SERVICES, INC. BOARD ARE ALSO MEMBERS OF THE Q FOUNDATION, INC. BOARD. ON AVERAGE, EACH BOARD MEMBER SPENDS APPROXIMATELY ONE HOUR PER WEEK SERVING EACH ORGANIZATION. | OVERLAP OF BOARD MEMBERS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Q FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4243 4TH AVENUE SOUTH | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55409 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260138861 | EIN |
| Primary Activities | COMMUNITY HEALTH & WELLNESS | PrimaryActivities |
| Legal Domicile State | MN | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 11A, I | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHSIDE COMMUNITY HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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