LEMARS AREA DIALYSIS SERVICES: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
LEMARS AREA DIALYSIS SERVICES (EIN 20-4980796)
Tax period
2011-07-01 to 2012-06-30
Filed
2012-10-31
IRS object ID
201243059349301254
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

FieldValueIRS element (for citing)
Timestamp2012-10-31T14:42:26-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WILLIAMS & COMPANY PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line121 1ST AVENUE NWAddressLine1
CityLE MARSCity
StateIAState
ZIP Code51031ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN204980796EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LE MARS AREA DIALYSIS SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLEMANameControl
Phone7125467871Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 - 1ST ST SWAddressLine1
CityLE MARSCity
StateIAState
ZIP Code51031ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMIKE DONLINName
TitlePRESIDENTTitle
Phone7125467871Phone
Date Signed2012-11-01DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJEFFREY S PETERS CPAName
Phone7125467801Phone
Date Prepared2012-10-31DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMIKE DONLINNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1714 LINCOLN ST NEAddressLine1
CityLE MARSCity
StateIAState
ZIP Code51031ZIPCode
FieldValueIRS element (for citing)
Gross Receipts46772GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2006YearFormation
State Legal DomicileIAStateLegalDomicile
Activity Or Mission DescriptionTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURROUNDING REGION.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year140077ContributionsGrantsPriorYear
Contributions Grants Current Year2990ContributionsGrantsCurrentYear
Program Service Revenue CY43771ProgramServiceRevenueCY
Investment Income Prior Year2673InvestmentIncomePriorYear
Investment Income Current Year11InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year142750TotalRevenuePriorYear
Total Revenue Current Year46772TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year633TotalFundrsngExpCurrentYear
Other Expense Prior Year33124OtherExpensePriorYear
Other Expenses Current Year575673OtherExpensesCurrentYear
Total Expenses Prior Year33124TotalExpensesPriorYear
Total Expenses Current Year575673TotalExpensesCurrentYear
Revenues Less Expenses Prior Year109626RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-528901RevenuesLessExpensesCY
Total Assets BOY1749955TotalAssetsBOY
Total Assets EOY1667911TotalAssetsEOY
Total Liabilities BOY441010TotalLiabilitiesBOY
Total Liabilities EOY887867TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1308945NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY780044NetAssetsOrFundBalancesEOY
Mission DescriptionTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURROUNDING REGION.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense534105Expense
DescriptionTO OPERATE A KIDNEY DIALYSIS CENTER IN LE MARS, IOWA TO TREAT PATIENTS IN LE MARS AND THE SURROUNDING REGIONDescription
Total Program Service Expense534105TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMIKE DONLINNamePerson
Telephone Number7125463492TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1714 LINCOLN ST NEAddressLine1
CityLE MARSCity
StateIAState
ZIP Code51031ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
KIRK KLOHS
TREASURER1.00XX000
JAMES GEORGE
DIRECTOR1.00XX000
KAREN DRECKMAN
SECRETARY1.00XX000
RANDY REARDON
CHAIR1.00XX000
STEVE OHM
VICE CHAIR1.00X000
MIKE DONLIN
PRESIDENT1.00X000
DR LIEM-SOM OEI
MEDICAL DIRE1.00XX000
FieldValueIRS element (for citing)
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
All Other Contributions2990AllOtherContributions
Total Contributions2990TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROGRAM SERVICE REVENUEDescription
Business Code621500BusinessCode
Total Revenue Column43771TotalRevenueColumn
Related Or Exempt Function Income43771RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue43771TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column11TotalRevenueColumn
Exclusion$11ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column46772TotalRevenueColumn
Related Or Exempt Function Income43771RelatedOrExemptFunctionIncome
Exclusion$11ExclusionAmount

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total276414Total
Program Services235819ProgramServices
Management And General40595ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1753Total
Program Services1753ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total2638Total
Program Services2638ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total71171Total
Program Services71171ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8031Total
Program Services8031ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total23303Total
Program Services23303ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total22693Total
Program Services22693ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total15450Total
Program Services15450ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total94867Total
Program Services94867ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total8533Total
Program Services8533ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesFundraisingFundraising
REPAIRS & MAINTENANCE2755727557
SUPPLIES1474614746
LEASED EQUIPMENT61606160
FUND RAISING633633

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1724Total
Program Services1384ProgramServices
Management And General340ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total575673Total
Program Services534105ProgramServices
Management And General40935ManagementAndGeneral
Fundraising633Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2063BOY
EOY45915EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14552BOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY89000BOY
EOY59000EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY3620EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1668260LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec108900LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY171510BOY
EOY1559360EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY15BOY
EOY16EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1472815BOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1749955BOY
EOY1667911EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
EOY288896EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY441010BOY
EOY598971EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY441010BOY
EOY887867EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1308945BOY
EOY780044EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1308945BOY
EOY780044EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1749955BOY
EOY1667911EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-528901ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1304086OtherCostOrOtherBasis
Depreciation46276Depreciation
Book Value1257810BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis364174OtherCostOrOtherBasis
Depreciation62624Depreciation
Book Value301550BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1559360TotalOfBookValueLandBuildings

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ADDITIONAL INFORMATIONFORM 990SCHEDULE A PART I, LINE 3- LE MARS AREA DIALYSIS SERVICES DOES NOT MEET THE DEFINITION OF "HOSPITAL FACILITY" FOR PURPOSE OF THE SCHEDULE H
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BFORM 990 IS PROVIDED TO THE GOVERNING BODY FOR REVIEW BEFORE IT IS FILED
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CTHE CENTER REQUIRES BOARD MEMBERS TO DISCLOSE AND REVIEW CONFLICTS OF INTEREST ANNUALLY
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE CLINIC MANAGER'S WAGE WAS APPROVED BY THE BOARD AFTER REVIEW OF WAGE AND SALARY DATA RECIEVED FROM FRESENIOUS MEDICAL CARE WHICH IS THE ENTITY THAT PAYS THE STAFF AT THE CENTER
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19ALL APPROPRIATE DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC INCLUDING FORM 990 & FORM 1023 APPLICATIONS DURING NORMAL BUSINESS HOURS AT THE LE MARS AREA DIALYSIS SERVICES OFFICE AT 714 LINCOLN ST NE PO BOX 10, LE MARS, IA 51031

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