SIOUXLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SIOUXLAND COMMUNITY HEALTH CENTER (EIN 42-1374894)
- Tax period
- 2011-02-01 to 2012-01-31
- Filed
- 2012-09-13
- IRS object ID
- 201212579349300806
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule K
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-09-13T10:06:13-05:00 | Timestamp |
| Tax Period End Date | 2012-01-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 658062523 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-02-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421374894 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIOUXLAND COMMUNITY HEALTH CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % MICHELLE STEPHAN | InCareOfName |
| Name Control | SIOU | NameControl |
| Phone | 7122522477 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 NEBRASKA STREET | AddressLine1 |
| City | SIOUX CITY | City |
| State | IA | State |
| ZIP Code | 511025410 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHELLE STEPHAN | Name |
| Title | CEO | Title |
| Date Signed | 2012-07-27 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Brian D Todd | Name |
| Phone | 4178658701 | 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 | MICHELLE STEPHAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 NEBRASKA STREET | AddressLine1 |
| City | SIOUX CITY | City |
| State | IA | State |
| ZIP Code | 51102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17160261 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SLANDCHC.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1991 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | TO BE A PATIENT-CENTERED MEDICAL HOME THAT IMPROVES THE PHYSICAL, DENTAL, AND BEHAVIORAL HEALTH OF THE SIOUXLAND COMMUNITY WHILE ELIMINATING ACCESS BARRIERS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 223 | TotalNbrEmployees |
| Total Nbr Volunteers | 18 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 5189358 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4775866 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 10881613 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 12368531 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6307 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5489 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -10080 | OtherRevenuePriorYear |
| Other Revenue Current Year | -3431 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 16067198 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17146455 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 57110 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 75136 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9194757 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10661288 | 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 | 6495433 | OtherExpensePriorYear |
| Other Expenses Current Year | 6501484 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15747300 | TotalExpensesPriorYear |
| Total Expenses Current Year | 17237908 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 319898 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -91453 | RevenuesLessExpensesCY |
| Total Assets BOY | 17388280 | TotalAssetsBOY |
| Total Assets EOY | 17326791 | TotalAssetsEOY |
| Total Liabilities BOY | 8371564 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 8905516 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9016716 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8421275 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF SIOUXLAND COMMUNITY HEALTH CENTER IS TO PROVIDE PRIMARY HEALTH CARE THAT ELIMINATES ACCESS BARRIERS AND IMPROVES THE HEALTH OF THE SIOUXLAND COMMUNITY. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 8289063 | Expense |
| Grants | 75136 | Grants |
| Revenue | 7377789 | Revenue |
| Description | SIOUXLAND CHC PROVIDES MEDICAL CARE SERVICES, INCLUDING: PRIMARY MEDICAL CARE, CHRONIC ILLNESS MANAGEMENT, PREVENTION, LABORATORY, RADIOLOGY, HIV/AIDS, BEHAVIORAL HEALTH, INTERPRETIVE, AND FINANCIAL ASSISTANCE. IN ADDITION, CARDIOVASCULAR, SURGERY, PODIATRY, NEPHROLOGY, ORTHOPAEDICS, PLASTIC SURGERY, AND OPTHALMOLOGY SERVICES ARE PROVIDED BY VOLUNTEER SPECIALIST PROVIDERS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3659317 | Expense |
| Revenue | 3257023 | Revenue |
| Description | SIOUXLAND CHC PROVIDES GENERAL DENTAL SERVICES, INCLUDING: EXAMS, CLEANINGS, FILLINGS, ROOT CANALS, AND EXTRACTIONS. EMERGENCY SERVICES ARE ALSO AVAILABLE. FOR SITUATIONS THAT ARE BEYOND THE SCOPE OF THE GENERAL DENTRISTRY PRACTICE, REFERRAL SERVICES ARE AVAILABLE. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1947862 | Expense |
| Revenue | 1733719 | Revenue |
| Description | THE SIOUXLAND CHC PHARMACY SERVES AS A PHARMACY HOME FOR HEALTH CENTER PATIENTS WHILE OFFERING DISCOUNTED MEDICATIONS AND LINKAGE TO PATIENT ASSISTANCE PROGRAMS. CLINICAL PHARMACISTS ARE ALSO ON STAFF TO PROVIDE SERVICES THAT ARE INTEGRATED WITH THE PATIENTS PRIMARY MEDICAL CARE. THE CLINICAL PHARMACISTS REVIEW MEDICATIONS WITH PATIENTS TO ENSURE PATIENT SAFETY, HEALTH LITERACY, AND PROPER MANAGEMENT OF MEDICATIONS AND CHRONIC HEALTH CONDITIONS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 13896242 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 32 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 223 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | 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 | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MICHELLE STEPHAN | NamePerson |
| Telephone Number | 7122522477 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 NEBRASKA STREET | AddressLine1 |
| City | SIOUX CITY | City |
| State | IA | State |
| ZIP Code | 51102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| JIM SPENCER | ||||||||
| TREASURER THROUGH 11/2011 | 1.0 | X | X | 0 | 0 | 0 | ||
| RONDA KEENAN RN MS | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| COREY WRENN | ||||||||
| PRESIDENT | 1.0 | X | X | 0 | 0 | 0 | ||
| ALICE KELLY FERDIG | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| JENNIFER GOMEZ | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| MARY KAPTAIN-DAHLEN | ||||||||
| DIRECTOR BEGINNING 10/2011 | 1.0 | X | 0 | 0 | 0 | |||
| BIBI JAURON | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| MARIA RUNDQUIST | ||||||||
| DIRECTOR THROUGH 05/2011 | 1.0 | X | 0 | 0 | 0 | |||
| JOAN KELLY | ||||||||
| SECRETARY | 1.0 | X | X | 0 | 0 | 0 | ||
| GEORGE BOYKIN | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| NANCY METCALF | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| OMAR SUAREZ | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| GARY BURTON | ||||||||
| DIRECTOR THROUGH 08/2011 | 1.0 | X | 0 | 0 | 0 | |||
| JOSEPH WRIGHT | ||||||||
| DIRECTOR THROUGH 01/2012 | 1.0 | X | 0 | 0 | 0 | |||
| KELLEY MCCARTHY | ||||||||
| DIRECTOR BEGINNING 02/2011 | 1.0 | X | 0 | 0 | 0 | |||
| CURTIS HANSON | ||||||||
| DIRECTOR FROM 02/2011-05/2011 | 1.0 | X | 0 | 0 | 0 | |||
| MICHELLE STEPHAN RN BSN | ||||||||
| CEO | 40.0 | X | 142907 | 0 | 31556 | |||
| BRADLEY WHITSELL | ||||||||
| CFO THROUGH 03/2011 | 40.0 | X | 17166 | 0 | 1251 | |||
| JAN ANDERSON CPA MBA | ||||||||
| CFO BEGINNING 04/2011 | 40.0 | X | 74023 | 0 | 9577 | |||
| KRISTI WALZ MD | ||||||||
| CO-MEDICAL DIRECTOR | 40.0 | 215845 | 0 | 28597 | X | |||
| RYAN MCKENNA MD | ||||||||
| DENTAL DIRECTOR | 40.0 | 188322 | 0 | 30317 | X | |||
| THOR SWANSON MD | ||||||||
| CO-MEDICAL DIRECTOR | 40.0 | 208057 | 0 | 26277 | X | |||
| GARY HATTAN MD | ||||||||
| PHYSICIAN | 40.0 | 205414 | 0 | 27740 | X | |||
| JULIA HEATON MD | ||||||||
| PHYSICIAN | 40.0 | 170449 | 0 | 19805 | X | |||
| JONATHAN TAYLOR MD | ||||||||
| PHYSICIAN | 40.0 | 168235 | 0 | 17438 | X | |||
| BRENDA HAUSMAN-MILLER DDS | ||||||||
| DENTIST | 40.0 | 166475 | 0 | 27088 | X | |||
| DAVID FALDMO pa | ||||||||
| ASSISTANT MEDICAL DIRECTOR | 40.0 | 168979 | 0 | 27252 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1725872 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 246898 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| INCONCERT CARE INC | |
| COMPUTER SERVICES | 159723 |
| BKD LLP | |
| AUDIT/TAX/CONSULTING | 120707 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Fundraising Events | 12390 | FundraisingEvents |
| Government Grants | 3366207 | GovernmentGrants |
| All Other Contributions | 1397269 | AllOtherContributions |
| Noncash Contributions | 1350071 | NoncashContributions |
| Total Contributions | 4775866 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICES | 624100 | 11955834 | 11955834 |
| OTHER REVENUE | 624100 | 412697 | 412697 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 12368531 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5939 | TotalRevenueColumn |
| Exclusion | $5,939 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 450 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -450 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -450 | TotalRevenueColumn |
| Exclusion | -$450 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 9925 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 12390 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 13356 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -3431 | TotalRevenueColumn |
| Exclusion | -$3,431 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17146455 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12368531 | RelatedOrExemptFunctionIncome |
| Exclusion | $2,058 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75136 | Total |
| Program Services | 75136 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1009521 | Total |
| Program Services | 723434 | ProgramServices |
| Management And General | 286087 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7941885 | Total |
| Program Services | 6446561 | ProgramServices |
| Management And General | 1495324 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 258062 | Total |
| Program Services | 206527 | ProgramServices |
| Management And General | 51535 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 808495 | Total |
| Program Services | 623315 | ProgramServices |
| Management And General | 185180 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 643325 | Total |
| Program Services | 515869 | ProgramServices |
| Management And General | 127456 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27301 | Total |
| Management And General | 27301 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119776 | Total |
| Management And General | 119776 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 700250 | Total |
| Program Services | 691850 | ProgramServices |
| Management And General | 8400 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58723 | Total |
| Program Services | 5984 | ProgramServices |
| Management And General | 52739 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 353459 | Total |
| Program Services | 186743 | ProgramServices |
| Management And General | 166716 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111306 | Total |
| Program Services | 78619 | ProgramServices |
| Management And General | 32687 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 166058 | Total |
| Program Services | 103076 | ProgramServices |
| Management And General | 62982 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68782 | Total |
| Program Services | 17304 | ProgramServices |
| Management And General | 51478 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 156082 | Total |
| Program Services | 80769 | ProgramServices |
| Management And General | 75313 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 323115 | Total |
| Management And General | 323115 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 654349 | Total |
| Program Services | 513878 | ProgramServices |
| Management And General | 140471 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29498 | Total |
| Management And General | 29498 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 1175422 | 1175422 | |
| LICENSES, DUES & SUBSCRIPTIONS | 73374 | 5794 | 67580 |
| RECRUITING | 24232 | 24232 | |
| MEDICAL SUPPLIES & DRUGS | 2445961 | 2445961 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13796 | Total |
| Management And General | 13796 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17237908 | Total |
| Program Services | 13896242 | ProgramServices |
| Management And General | 3341666 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 260354 | BOY |
| EOY | 287788 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2654989 | BOY |
| EOY | 3249368 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 315613 | BOY |
| EOY | 169167 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1154141 | BOY |
| EOY | 1269612 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 270243 | BOY |
| EOY | 340289 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 236561 | BOY |
| EOY | 288077 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 14032012 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2309522 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12331379 | BOY |
| EOY | 11722490 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165000 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17388280 | BOY |
| EOY | 17326791 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1015436 | BOY |
| EOY | 1107395 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6525640 | BOY |
| EOY | 6270112 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 830488 | BOY |
| EOY | 1528009 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8371564 | BOY |
| EOY | 8905516 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8786368 | BOY |
| EOY | 8105188 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 230348 | BOY |
| EOY | 316087 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9016716 | BOY |
| EOY | 8421275 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17388280 | BOY |
| EOY | 17326791 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -91453 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -503988 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5215284 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4465931 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4932289 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5189538 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4775866 | CurrentTaxYear |
| Total | 24578908 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5215284 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4465931 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4932289 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5189538 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4775866 | CurrentTaxYear |
| Total | 24578908 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 2859911 | AmountsSubstContributorsTotal |
| Public Support Total170 | 21718997 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 276223 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 102968 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10863 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6307 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5939 | CurrentTaxYear |
| Total | 402300 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 24981208 | TotalSupport |
| Gross Receipts From Admissions Etc | 49417590 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.86941 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.85588 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER LOBBYING ACTIVITIES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1(I) | ReturnReference |
| Explanation | THE ORGANIZATION PAID DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE IOWA PRIMARY CARE ASSOCIATION. A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1197727 | OtherCostOrOtherBasis |
| Book Value | 1197727 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10550128 | OtherCostOrOtherBasis |
| Depreciation | 1317903 | Depreciation |
| Book Value | 9232225 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1898427 | OtherCostOrOtherBasis |
| Depreciation | 859801 | Depreciation |
| Book Value | 1038626 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 385730 | OtherCostOrOtherBasis |
| Depreciation | 131818 | Depreciation |
| Book Value | 253912 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 11722490 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| INTEREST RATE SWAP | $1,328,009 |
| EST AMT DUE TO 3RD PARTY | $200,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1528009 | TotalOfAmounts |
| Total Revenue | 17146455 | TotalRevenue |
| Total Expenses | 17237908 | TotalExpenses |
| Excess Or Deficit For Year | -91453 | ExcessOrDeficitForYear |
| Other | -$503,988 | OtherAmount |
| Total Adjustments | -503988 | TotalAdjustments |
| Excess Or Deficit Per FS | -595441 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 16670055 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 13782 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | -497521 | OtherRevenues |
| Revenue Not Rptd F990 | -483739 | RevenueNotRptdF990 |
| Revenue Subtotal | 17153794 | RevenueSubtotal |
| Other Revenues Not Included | -7339 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -7339 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 17146455 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 17265496 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 13782 | DonatedServicesUseOfFacilities |
| Other Expenses Included | 13806 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 27588 | ExpensesNotRptdF990 |
| Expenses Subtotal | 17237908 | ExpensesSubtotal |
| Total Expenses Per Form990 | 17237908 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| UNCERTAIN TAX POSITIONS | SCHEDULE D, PART X, LINE 2 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| OTHER CHANGES IN NET ASSETS | SCHEDULE D, PART XI, LINE 8 | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT $(497,521) DONATED AUCTION ITEMS ( 6,467) ---------- $(503,988) |
| OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12 | SCHEDULE D, PART XII, LINE 2D | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT $(497,521) |
| OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 | SCHEDULE D, PART XII, LINE 4B | SPECIAL EVENT EXPENSES $(13,356) LOSS ON SALE OF FIXED ASSETS (450) DONATED AUCTION ITEMS 6,467 --------- $( 7,339) |
| OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25 | SCHEDULE D, PART XIII, LINE 2D | SPECIAL EVENT EXPENSES $13,356 LOSS ON SALE OF FIXED ASSETS 450 --------- $13,806 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | FALL DINNER | NameOfEvent1 |
| Gross Receipts Event1 | 19315 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 10865 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 8450 | GrossRevenueEvent1 |
| Food And Beverage Event1 | 4399 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 200 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 7707 | OtherDirectExpensesEvent1 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Total | 19315 | GrossReceiptsTotal |
| Charitable Contributions Total | 10865 | CharitableContributionsTotal |
| Gross Revenue Total Events | 8450 | GrossRevenueTotalEvents |
| Food And Beverage Total Events | 4399 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 200 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 7707 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 12306 | DirectExpenseSummaryEvents |
| Net Income Summary | -3856 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEBRASKA AIDS PROJECT | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 S 77TH ST STE A | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68114 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 470786622 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 75136 | AmountOfCashGrant |
| Purpose Of Grant | HIV PART B & HUD HOUSING | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | MONITORING OF GRANT FUNDS | Identifier |
| Return Reference | SCHEDULE I, PART I, LINE 2 | ReturnReference |
| Explanation | NEBRASKA AIDS PROJECT CONTINUED TO BE A SUBCONTRACTED AGENCY IN ORDER TO PROVIDE CONTRACTUAL HIV/AIDS SERVICES IN SOUTHWEST IA. THEY WERE CHOSEN ON THE BASIS OF PRIOR EXPERIENCE WITH WORKING WITH TARGETED POPULATION, AND STAFF CREDENTIALS/EXPERIENCE. THE AGENCY SUBMITS MONTHLY FINANCIAL REPORTS WITH EXPENSE DOCUMENTATION AND TIME TRACKING IN ORDER TO BE REIMBURSED. THEY ALSO SUBMIT THEIR ANNUAL AUDIT FOR REVIEW AND AN ON-SITE MONITORING REVIEW IS PERFORMED ANNUALLY. | 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 | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHELLE STEPHAN RN BSN | |||||||||||||
| 126298 | 0 | 16500 | 0 | 109 | 0 | 7645 | 0 | 23911 | 0 | 174463 | 0 | 0 | 0 |
| KRISTI WALZ MD | |||||||||||||
| 211708 | 0 | 0 | 0 | 4137 | 0 | 10883 | 0 | 17714 | 0 | 244442 | 0 | 0 | 0 |
| GARY HATTAN MD | |||||||||||||
| 204440 | 0 | 0 | 0 | 974 | 0 | 10346 | 0 | 17394 | 0 | 233154 | 0 | 0 | 0 |
| JULIA HEATON MD | |||||||||||||
| 170042 | 0 | 0 | 0 | 407 | 0 | 8548 | 0 | 11257 | 0 | 190254 | 0 | 0 | 0 |
| JONATHAN TAYLOR MD | |||||||||||||
| 164077 | 0 | 0 | 0 | 4158 | 0 | 0 | 0 | 17438 | 0 | 185673 | 0 | 0 | 0 |
| BRENDA HAUSMAN-MILLER DDS | |||||||||||||
| 149702 | 0 | 13600 | 0 | 3173 | 0 | 8700 | 0 | 18388 | 0 | 193563 | 0 | 0 | 0 |
| DAVID FALDMO pa | |||||||||||||
| 156145 | 0 | 10000 | 0 | 2834 | 0 | 8603 | 0 | 18649 | 0 | 196231 | 0 | 0 | 0 |
| RYAN MCKENNA MD | |||||||||||||
| 168145 | 0 | 13600 | 0 | 6577 | 0 | 9655 | 0 | 20662 | 0 | 218639 | 0 | 0 | 0 |
| THOR SWANSON MD | |||||||||||||
| 207689 | 0 | 0 | 0 | 368 | 0 | 10653 | 0 | 15624 | 0 | 234334 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | NON-FIXED PAYMENTS | Identifier |
| Return Reference | SCHEDULE J, PART 1, LINE 7 | ReturnReference |
| Explanation | THE BONUSES PAID TO EMPLOYEES ARE COMPUTED BASED ON PERFORMANCE, SUBJECT TO THE DISCRETION OF THE CEO. BONUSES ARE ALSO COMPUTED IF THE EMPLOYEE IS "CAPPED" ON THEIR SALARY RANGE. THE CEO OF THE ORGANIZATION ALSO RECEIVED A BONUS THIS YEAR. THE BOARD OF DIRECTORS DETERMINES WHETHER A BONUS WILL BE PAID TO THE CEO DURING THE ANNUAL PERFORMANCE EVALUATION. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WOODBURY COUNTY IOWA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 426005221 | IssuerEIN |
| Date Issued | 2007-09-25 | DateIssued |
| Issue Price | 7000000 | IssuePrice |
| Description Of Purpose | CONSTRUCTION OF NEW FACILITY | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 0 | AmountRetired |
| Amount Bond Defeased | 0 | AmountBondDefeased |
| Total Proceeds | 7000000 | TotalProceeds |
| Amount In Reserve Fund | 0 | AmountInReserveFund |
| Capitalized Interest | 0 | CapitalizedInterest |
| Refunding Escrow | 0 | RefundingEscrow |
| Issuance Costs From Proceeds | 100000 | IssuanceCostsFromProceeds |
| Credit Enhancement | 0 | CreditEnhancement |
| Working Capital Expenditures | 0 | WorkingCapitalExpenditures |
| Capital Expenditures | 6900000 | CapitalExpenditures |
| Other Spent Proceeds | 0 | OtherSpentProceeds |
| Amount Unspent | 0 | AmountUnspent |
| Year Of Subst Completion | 2009 | YearOfSubstCompletion |
| Current Refunding | false | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | false | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | false | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | true | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | false | Form8038TFiled |
| Variable Rate Issue | true | VariableRateIssue |
| Hedge Identified In Books And Recds | true | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLS FARGO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 20. | TermOfHedge |
| Superintegrated Hedge | false | SuperintegratedHedge |
| Hedge Terminated | false | HedgeTerminated |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
Name Of GIC Provider NameOfGICProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Exception To Rebate | false | ExceptionToRebate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArt | |
| Art Historical Treasures | ArtHistoricalTreasures | |
| Art Fractional Interest | ArtFractionalInterest |
Books And Publications BooksAndPublications
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 1213 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Clothing And Household Goods | ClothingAndHouseholdGoods | |
| Cars And Other Vehicles | CarsAndOtherVehicles | |
| Boats And Planes | BoatsAndPlanes | |
| Intellectual Property | IntellectualProperty | |
| Securities Publicly Traded | SecuritiesPubliclyTraded | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStock | |
| Securities Prtnrshp Trust Intrsts | SecuritiesPrtnrshpTrustIntrsts | |
| Securities Miscellaneous | SecuritiesMiscellaneous | |
| Qualified Contrib Hist Struct | QualifiedContribHistStruct | |
| Qualified Contrib Other | QualifiedContribOther | |
| Real Estate Residential | RealEstateResidential | |
| Real Estate Commercial | RealEstateCommercial | |
| Real Estate Other | RealEstateOther | |
| Collectibles | Collectibles | |
| Food Inventory | FoodInventory |
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 93 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 1341916 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | Taxidermy | |
| Historical Artifacts | HistoricalArtifacts | |
| Scientific Specimens | ScientificSpecimens | |
| Archaeological Artifacts | ArchaeologicalArtifacts |
Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | AUCTION ITEMS | 66 | 6467 | FMV |
| X | INVITATIONS | 1 | 475 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | NUMBER OF CONTRIBUTIONS | Identifier |
| Return Reference | SCHEDULE M, PART I, LINES 20, 25 & 26, COLUMN (B) | ReturnReference |
| Explanation | THE ORGANIZATION RECEIVED DRUGS AND MEDICAL SUPPLIES 93 SEPARATE TIMES THROUGHOUT THE YEAR. ADDITIONALLY, THE ORGANIZATION RECEIVED 66 ITEMS DONATED FOR ITS SILENT AUCTIONS RELATED TO ITS SPECIAL EVENTS, AND ONE DONOR PROVIDED INVITATIONS FOR THE ORGANIZATION. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART III, LINE 1 | SIOUXLAND COMMUNITY HEALTH CENTER IS A NONPROFIT ORGANIZATION DEDICATED TO MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY AND SUPPORTS THE PHILOSOPHY OF THE PATIENT-CENTERED MEDICAL HOME. OUR MISSION IS TO BE A PATIENT-CENTERED MEDICAL HOME THAT IMPROVES THE PHYSICAL, DENTAL, AND BEHAVIORAL HEALTH OF THE SIOUXLAND COMMUNITY WHILE ELIMINATING ACCESS BARRIERS. OUR VALUES INCLUDE COMMITMENT, ADVANCEMENT, RESPECT, EXCELLENCE, AND SUPPORT. |
| PROGRAM SERVICES | FORM 990, PART III, LINE 4 | SIOUXLAND COMMUNITY HEALTH CENTER (SCHC) PROVIDES VITAL PRIMARY HEALTH CARE SERVICES TO CITIZENS OF THE COMMUNITY WHO ARE IN NEED OF A HEALTH CARE HOME. THESE SERVICES INCLUDE: PRIMARY MEDICAL CARE, DENTAL CARE, LABORATORY, PHARMACY, HIV/AIDS & HEPATITIS PROGRAM, SOCIAL, INTERPRETIVE, AND FINANCIAL SERVICES. 22,137 PATIENTS WERE SERVED IN FISCAL YEAR 01/31/2012. |
| PROGRAM SERVICE ACTIVITY #1 | FORM 990, PART III, LINE 4A | PRIMARY MEDICAL CARE ELEVEN MEDICAL PROVIDER TEAMS ARE ON STAFF TO ENSURE ACCESS TO A MEDICAL HOME, OR PLACE OF CONSISTENT AND CONTINUED CARE FOR ALL PATIENTS SERVED AT SCHC. IN ADDITION TO PRIMARY MEDICAL CARE, COMMUNITY PROVIDERS SPECIALIZING IN CARDIOVASCULAR, SURGERY, PODIATRY, AND OPHTHALMOLOGY VOLUNTEER SERVICES AT THE HEALTH CENTER. AS A PARTICIPANT IN THE FEDERAL HEALTH DISPARITIES COLLABORATIVES, A NATIONAL EFFORT TO ELIMINATE DISPARITIES AND IMPROVE SERVICE DELIVERY SYSTEMS, SCHC OFFERS A RESOURCE FOR CHRONIC ILLNESS MANAGEMENT AND PREVENTION. FOCUS AREAS FOR THESE COLLABORATIVES INCLUDE CARDIOVASCULAR, DIABETES, ASTHMA, AND DEPRESSION. IN ADDITION TO THESE COLLABORATIVES, A SMOKING CESSATION PROGRAM BEGAN IN JANUARY 2008. FOR CHILDREN FROM BIRTH THROUGH AGE 18, SIOUXLAND CHC OFFERS MANY SERVICES TO ENSURE HEALTHY STARTS AND PROPER DEVELOPMENT. SERVICES FOR CHILDREN INCLUDE VISION AND HEARING SCREENING, HEIGHT AND WEIGHT CHECKS, EYE EXAMS AND VACCINATIONS. BLOOD LEAD POISONING PREVENTION IS ALSO A PART OF THE CHILD HEALTH PROGRAM. LABORATORY SERVICES CURRENTLY, 93% OF ALL LABORATORY TESTS ARE PERFORMED ONSITE. THIS ENSURES A RAPID TURNAROUND FOR DIAGNOSIS AND MONITORING OF CHRONIC ILLNESS. THE SCHC LABORATORY IS CERTIFIED UNDER THE CLINICAL LABORATORY IMPROVEMENT AMENDMENTS (CLIA) TO ENSURE QUALITY SERVICES. HIV/AIDS AND HEPATITIS PROGRAM THE HEALTH CENTER IS THE ONLY COMPREHENSIVE PROVIDER OF HIV CARE WITHIN A 100 MILE RADIUS. THE HIV TEAM AT SCHC SERVES THE TRI-STATE SIOUXLAND AREA AS WELL AS 18 NORTHWEST IOWA COUNTIES AS APPROXIMATELY 40% OF PATIENTS RECEIVING HIV/AIDS CARE LIVE IN RURAL AREAS. CARE FOR HIV/AIDS AND HEPATITIS AT SCHC IS A COMPREHENSIVE APPROACH. SERVICES INCLUDE PRIMARY MEDICAL CARE, DENTAL SERVICES, CASE MANAGEMENT, TRANSPORTATION AND HOUSING ASSISTANCE, AND LINKAGE TO OTHER SUPPORT AND SOCIAL SERVICES. IN 2009, THE HIV TEAM SERVED 117 PATIENTS. SOCIAL SERVICES THE SIOUXLAND CHC SOCIAL SERVICES TEAM LINKS PATIENTS TO NEEDED SERVICES AND RESOURCES. CASE MANAGEMENT, TRANSPORTATION ASSISTANCE, FINANCIAL SERVICES, AND SHORT-TERM MENTAL HEALTH COUNSELING SERVICES ARE OFFERED TO ENSURE THAT ALL PATIENT NEEDS ARE MET. TO HELP ELIMINATE BARRIERS TO CARE, THE SOCIAL SERVICES DEPARTMENT COLLABORATES WITH SEVERAL PARTNERS IN THE COMMUNITY INCLUDING THE CENTER, COUNCIL ON SEXUAL ASSAULT AND DOMESTIC VIOLENCE (CSADV), THE DEPARTMENT OF HUMAN SERVICES (DHS), HAVEN HOUSE, JACKSON RECOVERY CENTERS, SIOUXLAND AGING, WESTSIDE RESOURCE CENTER, AND WOMEN AWARE. INTERPRETIVE SERVICES TO FOSTER CULTURAL COMPETENCY AND PROVIDE PATIENT-FOCUSED CARE, SCHC EMPLOYS A TEAM OF INTERPRETERS. WHILE PROVIDING LANGUAGE TRANSLATION FOR SPANISH, VIETNAMESE, FRENCH, AND SOMALI, AN AT&T LANGUAGE LINE IS UTILIZED FOR TRANSLATION THAT IS NOT OFFERED ONSITE. THESE SERVICES ARE VALUED TO HELP MEET THE DIVERSE NEEDS OF THE COMMUNITY. FINANCIAL SERVICES TO PROVIDE ACCESS TO QUALITY AND AFFORDABLE HEALTHCARE, SIOUXLAND CHC OFFERS A SLIDING FEE DISCOUNT TO PATIENTS BASED ON INCOME ELIGIBILITY AND ACCEPTS MEDICAID (TITLE 19), MEDICARE (TITLE 18), HAWK-I (STATE CHIP), AND ALL PRIVATE INSURANCES. IN ADDITION TO FINANCIAL COUNSELORS, A DEPARTMENT OF HEALTH SERVICES OUTSTATION WORKER IS ONSITE TO ASSIST WITH ELIGIBILITY DETERMINATION AND APPLICATION PROCESSES. |
| PROGRAM SERVICE ACTIVITY #2 | FORM 990, PART III, LINE 4B | DENTAL CARE THE NUMBER OF PATIENTS SERVED IN THE DENTAL CLINIC IS GROWING EXPONENTIALLY. SPECIAL EFFORTS ARE IN PLACE TO RESPOND TO THE ORAL HEALTH NEEDS OF THE COMMUNITY, ESPECIALLY CHILDREN. THREE DENTAL PROVIDERS ARE ON STAFF TO ENSURE ACCESS TO DENTAL CARE. IN 2009, THE DENTAL TEAM BEGAN OUTREACH EFFORTS TO SCHOOLS AND OTHER COMMUNITY BASED AGENCIES AS A PROACTIVE APPROACH FOR LINKING CHILDREN TO A DENTAL HOME. IN ADDITION, THE I-SMILE PROGRAM UTILIZES A DENTAL HYGIENIST TO PROVIDE OUTREACH, EDUCATION, AND ORAL HEALTH SCREENINGS IN VARIOUS COMMUNITY SETTINGS. WHILE BUILDING COMMUNITY PARTNERSHIPS, THE I-SMILE PROGRAM FOCUSES ON SECURING DENTAL HOMES FOR CHILDREN UP TO AGE 14. THE MONTHLY BABY DAYS CLINIC CONTINUES TO BE A UNIQUE SERVICE OFFERED AT THE SCHC DENTAL CLINIC. TARGETED AT YOUNG CHILDREN FROM BIRTH THROUGH AGE 2, PARENTS HAVE AN OPPORTUNITY TO BRING THEIR CHILD TO THE CLINIC TO LEARN ABOUT EARLY DENTAL CARE AND PREVENTION OF BABY BOTTLE TOOTH DECAY. A COLLABORATION WITH MERCY MEDICAL CENTER IS ALSO IN PLACE TO HELP ADDRESS THE ORAL HEALTH NEEDS IN THE COMMUNITY. IN 2009, SIOUXLAND CHC AND MERCY CONTINUED TO PARTNER ON AN INITIATIVE TO ESTABLISH DENTAL HOMES FOR PATIENTS SEEKING CARE AT THE EMERGENCY ROOM FOR ORAL HEALTH PROBLEMS. THIS PROJECT, WHICH IS PARTIALLY FUNDED BY THE TRINITY HEALTH FOUNDATION, HELPS REDUCE COSTLY BURDENS AND BARRIERS TO CARE. |
| REVIEW OF THE FORM 990 | FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CEO AND CFO REVIEW THE RETURN PRIOR TO ITS SUBMISSION. A COPY OF THE 990 WILL BE DISTRIBUTED TO ALL BOARD MEMBERS PRIOR TO IT BEING FILED. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | A CONFLICT OF INTEREST POLICY IS STATED IN THE EMPLOYEE HANDBOOK. PER THE BYLAWS, IF A QUESTION CONCERNING A CONFLICT OF INTEREST FOR ANY DIRECTOR IS RAISED, A WRITTEN SECRET BALLOT MAY BE USED BY THE REMAINING DIRECTORS TO DETERMINE IF SUCH CONFLICT OF INTEREST EXISTS. SHOULD A CONFLICT OF INTEREST, PECUNIARY OR OTHERWISE, BE DETERMINED FOR ANY DIRECTOR, SUCH DIRECTOR SHALL BE EXCLUDED FROM VOTING ON THAT SUBJECT MATTER. A SIMPLE, AFFIRMATIVE MAJORITY OF THOSE PRESENT SHALL RULE. IN ALL EVENTS, A DIRECTOR SHALL DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST. |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINES 15A & 15B | THE CEO'S COMPENSATION WAS EVALUATED IN 2011, BY THE BOARD OF DIRECTORS, USING A PEER REVIEW. EACH YEAR A SALARY ANALYSIS IS DONE USING DATA OBTAINED LOCALLY AND REGIONALLY. THIS ANALYSIS IS COMPILED AND A RECOMMENDATION IS TAKEN TO THE BOARD. THE ANALYSIS/RECOMMENDATIONS ARE GROUPED BY TITLE OF THE POSITION. THE CEO'S YEARLY EVALUATION IS PREPARED BY THE BOARD AND THE SCORE IS CALCULATED TO DETERMINE THE CURRENT YEAR SALARY. THE SAME PROCESS IS FOLLOWED FOR THE KEY EMPLOYEES, THE ONLY DIFFERENCE BEING THAT THE CEO DOES THE REVIEW. |
| DOCUMENT DISCLOSURE | FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS WILL BE PROVIDED TO INQUIRING PARTIES UPON REQUEST. |
| OTHER CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 5 | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT $(497,521) DONATED AUCTION ITEMS ( 6,467) ---------- $(503,988) |