2012-12-05T12:18:02-06:00 2012-02-29 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2011-03-01 470548990 ONEWORLD COMMUNITY HEALTH CENTERS INC ONEW 4027344110 4920 SOUTH 30TH STREET NO 103 OMAHA NE 68107 ANDREA SKOLKIN 4027344110 2012-12-03 1 BARBARA J FAJEN P00400874 4023302660 2011 2016-02-24 21:20:13Z ANDREA SKOLKIN 4920 SOUTH 30TH STREET NO 103 OMAHA NE 68107 22195442 0 X WWW.ONEWORLDOMAHA.ORG X 1975 NE PRIMARY CARE SERVICES TO PATIENTS INCLUDE A FACE TO FACE VISIT WITH A MEDICAL PROVIDER TO ASSESS THEIR MEDICAL NEEDS. DENTAL SERVICES INCLUDE VISITS WITH DENTISTS OR HYGIENISTS TO PROVIDE TEETH CLEANING, ORAL EXAMS AND SOME RESTORATIVE SERVICES. BEHAVIORAL SERVICES INCLUDE PATIENTS SEEN BY THE BEHAVIORAL THERAPISTS AND PSYCHIATRISTS. PHARMACY SERVICES PROVIDE PRESCRIPTION MEDICATION TO ONEWORLD'S PATIENTS. ONEWORLD ALSO PROVIDES WIC SERVICES TO LOW INCOME MOTHERS AND CHILDREN. 17 17 273 30 0 0 11199919 12214818 7466526 9528042 77939 88827 362047 343435 19106431 22175122 367968 669653 0 0 8556439 9986600 0 0 0 8961344 9579751 17885751 20236004 1220680 1939118 11500794 14079914 1329237 1956700 10171557 12123214 X ONEWORLD COMMUNITY HEALTH CENTERS, IN PARTNERSHIP WITH THE COMMUNITY, PROVIDE CULTURALLY RESPECTFUL, QUALITY HEALTHCARE TO THE UNDERSERVED. 1 0 10807056 17623 5351856 MEDICAL CLINIC - TO PROVIDE HEALTH CARE SERVICES TO UNDERSERVED INDIVIDUALS IN OMAHA, PLATTSMOUTH AND 3 SCHOOL BASED HEALTH CLINICS. FOR THIS CURRENT YEAR, ONEWORLD PROVIDED 56,464 VISITS TO 19,507 PATIENTS. 1930317 992838 THE DENTAL CLINIC CONTINUED TO GROW AND IT PROVIDED 14,848 VISITS TO 6,038 PATIENTS. 5563809 2752209 THE PHARMACY DEPARTMENT CONTINUED TO GROW RESULTING IN INCREASED PATIENT VOLUME. IN THIS CURRENT YEAR, IT PROVIDED 71,904 SCRIPTS. 652030 652030 652030 ELECTRONIC HEALTH RECORDS IMPLEMENTATION 652030 652030 652030 18953212 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 8 0 1 273 1 0 0 0 0 0 1 1 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X CAROLINA APICELLA 4025028858 4920 SOUTH 30TH STREET 103 OMAHA NE 68107 X PAUL ESPOSITO 2.00 X X 0 0 0 ANDREW KLOECKNER 2.00 X X 0 0 0 DONOVAN HUTCHENS 2.00 X X 0 0 0 BRENT BLUME 2.00 X X 0 0 0 JENNIFER JONES 2.00 X X 0 0 0 BLANCA MEJIA 2.00 X 0 0 0 HEATH MELLO 2.00 X 0 0 0 CINDY NIEVES 2.00 X 0 0 0 JEREMY NORDQUIST 2.00 X 0 0 0 DAVE RIDDER 2.00 X 0 0 0 MARISELA RINCON 2.00 X 0 0 0 GABE ROMERO 2.00 X 0 0 0 ARMANDO SALGADO 2.00 X 0 0 0 PAULA SCHULZ 2.00 X 0 0 0 CONCEPCION TINOCO 2.00 X 0 0 0 DUSTIN ZABOKRTSKY 2.00 X 0 0 0 MARCY ZAUNA 2.00 X 0 0 0 ANDREA SKOLKIN 38.00 X 161906 0 20993 JOEL DOUGHERTY 20.00 X 95107 0 9846 CAROLINA APICELLA 32.00 X 94031 0 9170 PAUL BEUTLER 40.00 X 106195 0 8427 HANS DETHLEFS 20.00 X 156937 0 20151 ALEX DWORAK 36.00 X 115345 0 17914 THERESE HENNESSY 30.00 X 137493 0 5300 COLLEN SCHRAGE 40.00 X 105317 0 6769 972331 0 98570 6 0 1 0 HEARTLAND COMMUNITY HEALTH NETWORK 1536 CUMIN STREET OMAHA NE 68102 MEDICAL SERVICES 821054 ALLEY POYNER 1516 CUMING ST OMAHA NE 68102 ARCHITECT 507329 CUSTOM COMPUTING CORPORATION 11135 MILL VALLEY ROAD OMAHA NE 68154 BILLING SERVICES 283643 UNMC DEPT OF FAMILY MEDICINE 983075 NEBRASKA MEDICAL CENTER OMAHA NE 68198 MEDICAL SERVICES 260691 BAIRD HOLM LLP 1500 WOODMAN TOWER OMAHA NE 68102 LEGAL SERVICES 208754 7 586918 15000 6776959 4835941 3902601 12214818 MEDICAL CLINIC 621990 6051157 6051157 PHARMACY 446110 1834524 1834524 DENTAL 621990 1082762 1082762 SCHOOL CLINICS 621990 253328 253328 BEHAVIORAL HEALTH PROG 621990 75590 75590 230681 230681 9528042 76505 76505 66974 0 66974 66974 66974 12322 0 12322 12322 12322 75890 15000 20320 55570 55570 SALARY REIMBURSEMENT 900099 220891 220891 220891 22175122 9748933 0 211371 652030 652030 17623 17623 391053 391053 8070332 7748732 321600 208377 206351 2026 648604 584285 64319 668234 618392 49842 38982 38982 33048 33048 12901 12901 1069917 977571 92346 192066 164193 27873 4466750 4305176 161574 85093 75142 9951 645140 645140 55801 47895 7906 118806 90752 28054 392889 378781 14108 45581 45581 PHARMACY 1171939 1171939 BAD DEBT EXPENSE 720954 720954 MEDICAL SUPPLIES 203780 203780 LABORATORY 177539 177539 148565 82374 66191 20236004 18953212 1282792 0 3121 3684 6156000 6501213 910108 945241 472555 749260 364507 309449 115563 137527 219803 225131 6454685 3627947 1614848 2826738 1644289 2381671 11500794 14079914 757282 1120958 516811 508993 0 234685 55144 92064 1329237 1956700 X 9457768 11101562 713789 1021652 10171557 12123214 11500794 14079914 X 1939118 12539 X X 0 1 1 X 1 1 X 6559701 6854363 8485881 11199919 12214818 45314682 6559701 6854363 8485881 11199919 12214818 45314682 1128957 44185725 187627 172367 147657 136672 143479 787802 301941 276461 578402 46680886 34544753 0.94650 0.97160 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 11607 10000 197 21804 11000 607 11607 1.00000 0.00000 0.00000 1 0 1696863 946236 750627 2552022 2338303 213719 2205800 343408 1862392 2826738 DUE TO HEARTLAND NETWORK 51515 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 40549 92064 22175122 20236004 1939118 12539 12539 1951657 22507752 12539 299771 20320 332630 22175122 0 22175122 20556095 299771 20320 320091 20236004 0 20236004 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ONEWORLD IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ONEWORLD HAS RECEIVED A DETERMINATION LETTER THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX-EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE ONEWORLD TO MEET A COMMUNITY BENEFIT STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. ONEWORLD ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. ONEWORLD RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT FEBRUARY 29, 2012, ONEWORLD HAD NO UNCERTAIN TAX POSITIONS ACCRUED. WITH FEW EXCEPTIONS, ONEWORLD IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY U.S. FEDERAL, STATE OR LOCAL AUTHORITIES FOR YEARS BEFORE 2008. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT MILAGRO DINNER EXPENSE 20,320. PART XIII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT MILAGRO DINNER EXPENSE 20,320. DINNER 69090 5000 64090 500 9397 9948 SOFTBALL 16001 10000 6001 250 1 5799 0 5799 225 90890 15000 75890 750 9397 10173 20320 55570 1 HEARTLAND COMMUNITY HEALTH NETWORK INC 4920 S 30TH STREET SUITE 103 OMAHA NE 68107 272471697 501(C)(3) 652030 ASSISTANCE IN THE DEVELOPMENT OF ELECTRONIC HEALTH RECORDS TO 5 COMMUNITY HEALTH CENTERS IN NEBRASKA. 1 0 CAB RIDES, SMALL MEDICAL SUPPLIES AND PRESCRIPTION DRUGS 2000 17623 FAIR MARKET VALUE CAB RIDES, SMALL MEDICAL SUPPLIES AND PRESCRIPTION DRUGS FAIR MARKET VALUE FAIR MARKET VALUE PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ONEWORLD DETERMINES EACH PATIENT'S ELIGIBILITY TO QUALIFY FOR ASSISTANCE BY OBTAINING EACH PATIENT'S INCOME INFORMATION. THE DONATION STATUS OR THE EXEMPTION FROM THE SLIDING FEE SCALE APPLIED TO A PATIENT IS TO ASSIST THOSE PATIENTS WITHOUT THE MEANS TO PAY FOR MEDICAL CARE COSTS. THE FINANCIAL STATUS OF THE PATIENT IS ASSESSED BY THE PATIENT MEETING WITH A FINANCIAL COUNSELOR AND PROVIDING DOCUMENTATION OF FINANCIAL HARDSHIP. IF THE FINANCIAL COUNSELOR DETERMINES THAT PAYMENT IS NOT POSSIBLE THEN THE PATIENT MEETS WITH A SOCIAL SERVICES REPRESENTATIVE TO DETERMINE IF THE PATIENT QUALIFIES FOR DONATION STATUS. AS A TOOL AND TO MAINTAIN CONSISTENCY, THE REPRESENTATIVE FROM THE SOCIAL SERVICES DEPARTMENT USES THE DONATION STATUS QUESTIONAIRE TO MAKE THE ASSESSMENT. THE PATIENT CAN QUALIFY FOR DONATION STATUS FOR A PERIOD OF 1 TO 3 MONTHS. A REPORT DETAILING THE LIST OF PATIENTS QUALIFYING FOR DONATION STATUS IS REVIEWED BY THE CONTROLLER AND CEO OF ONEWORLD MONTHLY. X X 0 0 0 0 0 1 0 0 0 ANDREA SKOLKIN 136071 0 21961 0 3874 0 7422 0 13571 0 182899 0 0 0 HANS DETHLEFS 156937 0 0 0 0 0 7482 0 12669 0 177088 0 0 0 PART I, LINE 6 THE CHIEF EXECUTIVE OFFICER RECEIVED A BONUS FOR 2011 THAT WAS CONTINGENT ON THE FOLLOWING 5 FACTORS EQUALLY: 1) EMPLOYEE SATISFACTION 2) PATIENT SATISFACTION - OVERALL SCORE NOT UNDER 85% 3) NET OPERATING MARGIN BEFORE DEPRECIATION 4) AUDIT - UNQUALIFIED OPINION, NO MATERIAL WEAKNESSES 5) GOALS: NEW STRATEGIC PLAN, ENGAGED COMMUNITY ADVISORY GROUP, ENGAGED BOARD, ESTABLISH LEADERSHIP TRAINING FOR STAFF, SCHOOL CLINICS OPERATION. X 4 3877417 FAIR MARKET VALUE 0 1 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 IN 2011, ONEWORLD, IN PARTNERSHIP WITH THE LEARNING COMMUNITY CENTER, BEGAN PROVIDING COMPUTER CLASSES TO THE INDIVIDUALS IN NEED IN THE COMMUNITY. FORM 990, PART VI, SECTION B, LINE 11 BEFORE FILING FORM 990, A DRAFT IS PROVIDED TO THE CFO AND CEO FOR REVIEW. IF ANY CORRECTIONS OR CHANGES ARE NEEDED, THE CFO AND CEO COMMUNICATE THE CHANGES IN WRITING TO THE PREPARER. THE PREPARER ISSUES A REVISED DRAFT OF FORM 990 AND IT IS PROVIDED TO THE FINANCE COMMITTEE FOR DISCUSSION AND REVIEW. UPON ACCEPTANCE BY THE FINANCE COMMITTEE, THE FORM IS PRESENTED TO THE BOARD FOR THE FINAL APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C EACH NEW EMPLOYEE AND NEW BOARD MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY. THE POLICY IS ALSO REVISITED QUARTERLY AT EACH STAFF MEETING TO REMIND EMPLOYEES OF ANY TRANSACTIONS RESULTING IN CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION STRUCTURES AT ONEWORLD ARE REVIEWED AND APPROVED ANNUALLY. THE PROCESS BEGINS WITH AN ANNUAL SALARY COMPARISON ACROSS NATIONAL, REGIONAL, AND LOCAL SALARY SURVEYS AND ONEWORLDS SALARY RANGE STRUCTURES. IF ADJUSTMENTS ARE NEEDED FOR ANY RANGE TO REMAIN COMPETITIVE AGAINST THE MARKET, SUCH CHANGES ARE SUGGESTED AND REVIEWED FOR APPROVAL. ONEWORLD USES THE FOLLOWING PUBLISHED SALARY SURVEYS FOR COMPARISON: NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, IOWA/NEBRASKA PRIMARY CARE ASSOCIATION, NON-PROFIT ASSOCIATION OF THE MIDLANDS, HUMAN RESOURCE ASSOCIATION OF THE MIDLANDS, AND THE MEDICAL GROUP MANAGEMENT ASSOCIATION. ONEWORLD POSITION DESCRIPTIONS ARE COMPARED AGAINST THE SURVEY POSITION DESCRIPTIONS AND LIKE POSITION SALARIES ARE COMPARED AGAINST THE 25TH AND 75TH PERCENTILES OF SURVEY DATA. IF THERE ARE LARGE CHANGES IN THE MARKET FOR A POSITION, THIS INFORMATION IS ASSESSED AND A DETERMINATION IS MADE IF OUR RANGE IS COMPETITIVE OR SHOULD BE ADJUSTED. ONCE SURVEY ASSESSMENT IS COMPLETE, RECOMMENDATIONS ARE SENT TO THE ONEWORLD BOARD OF DIRECTORS FOR APPROVAL OF SALARY RANGES BY POSITION FOR THE YEAR. IN CONSIDERATION OF A SPECIFIC POSITION, SPECIFIC EMPLOYEE OR SPECIFIC CANDIDATE; ONEWORLD WILL TAKE INTO ACCOUNT ONE'S EXPERIENCE, EDUCATION, AND LEVEL OF RESPONSIBILITY TO DETERMINE WHERE ONE'S SALARY WOULD BE WITHIN THE APPROVED SALARY RANGE. POSITION DESCRIPTIONS ARE REVIEWED AND UPDATED EACH YEAR DURING ANNUAL REVIEWS IN THE EARLY SPRING. THE ANNUAL REVIEW OF SALARY RANGES TAKES PLACE IN THE LATE FALL/ EARLY WINTER OF EACH YEAR WITH BOARD APPROVAL BY FEBRUARY OF EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CURRENTLY, WE ARE WORKING ON A WEBSITE THAT WILL ULTIMATELY PUBLISH THIS INFORMATION FOR PUBLIC USE. FORM 990, PART VII, LINE 1A: JOEL DOUGHERTY, COO, SPEND AN AVERAGE OF 20.00 HOURS WORKING AT HEARTLAND COMMUNITY HEALTH NETWORK, INC., A UNRELATED ORGANIZATION, AS COO. CAROLINA APICELLA, CFO, SPEND AN AVERAGE OF 8.00 HOURS WORKING AT HEARTLAND COMMUNITY HEALTH NETWORK, INC., A UNRELATED ORGANIZATION, AS CFO. OF THE TOTAL $821,054, HEARTLAND COMMUNITY HEALTH NETWORK, INC. PAYS TO ONEWORLD COMMUNITY HEALTH CENTERS, INC., ONEWORLD COMMUNITY HEALTH CENTERS, INC. PAYS $50,365 TO MR. DOUGHERTY AND $20,031 TO MS. APICELLA. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 12,539. FORM 990, PART XI, LINE 2C: THERE HAVE BEEN NO CHANGES FROM THE PRIOR YEAR. THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT ACCOUNTANT AND HAS THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. UPON CONCLUSION OF THE AUDIT, THE AUDITING FIRM PRESENTS THE RESULTS AND FINDINGS TO THE AUDIT COMMITTEE. ONEWORLD COMMUNITY BUILDERS LLC 4980 S 30TH STREET SUITE 103 OMAHA NE 68107 270791687 FACILITY DEVELOPMENT NE 0 0 N/A LIVESTOCK COMMONS LLC 4980 S 30TH STREET SUITE 103 OMAHA NE 68107 270831017 LOW INCOME HOUSING NE 0 0 N/A