SAMUEL U RODGERS HEALTH CENTER INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
SAMUEL U RODGERS HEALTH CENTER INC (EIN 43-0899356)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-03
IRS object ID
201112159349300801
Schema version
2009v1.7
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)
Timestamp2011-08-03T09:19:36-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11201 Walnut Suite 1700AddressLine1
CityKansas CityCity
StateMOState
ZIP Code641062246ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN430899356EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Samuel U Rodgers Health Center IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSAMUNameControl
Phone8164744920Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1825 Euclid AvenueAddressLine1
CityKansas CityCity
StateMOState
ZIP Code64124ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameHILDA FUENTESName
TitleCEOTitle
Date Signed2011-07-01DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMichael J EngleName
Phone8162216300Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonHilda FuentesNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1825 Euclid AvenueAddressLine1
CityKansas CityCity
StateMOState
ZIP Code64124ZIPCode
FieldValueIRS element (for citing)
Gross Receipts17542654GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.rodgershealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1968YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionTHE CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE FOR ALL.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees268TotalNbrEmployees
Total Nbr Volunteers25TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year9736155ContributionsGrantsPriorYear
Contributions Grants Current Year10404698ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6311386ProgramServiceRevenuePriorYear
Program Service Revenue CY6792838ProgramServiceRevenueCY
Investment Income Prior Year3697InvestmentIncomePriorYear
Investment Income Current Year-2469InvestmentIncomeCurrentYear
Other Revenue Prior Year98781OtherRevenuePriorYear
Other Revenue Current Year86496OtherRevenueCurrentYear
Total Revenue Prior Year16150019TotalRevenuePriorYear
Total Revenue Current Year17281563TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year913533GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY681667GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year10437380SalariesEtcPriorYear
Salaries Etc Current Year10162483SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year91002TotalFundrsngExpCurrentYear
Other Expense Prior Year4144012OtherExpensePriorYear
Other Expenses Current Year5190455OtherExpensesCurrentYear
Total Expenses Prior Year15494925TotalExpensesPriorYear
Total Expenses Current Year16034605TotalExpensesCurrentYear
Revenues Less Expenses Prior Year655094RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1246958RevenuesLessExpensesCY
Total Assets BOY13752389TotalAssetsBOY
Total Assets EOY16036520TotalAssetsEOY
Total Liabilities BOY1275991TotalLiabilitiesBOY
Total Liabilities EOY1696156TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY12476398NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY14340364NetAssetsOrFundBalancesEOY
Mission DescriptionTHE CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE FOR ALL.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangetrueSignificantChange
Expense12708594Expense
Grants681667Grants
Revenue6792838Revenue
DescriptionSEE SCHEDULE ODescription
Total Program Service Expense12708594TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
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 OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
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 ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109620NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees268NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
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
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
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 OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMOStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBOB THEISNamePerson
Telephone Number8168894802TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1825 EUCLID AVENUEAddressLine1
CityKansas CityCity
StateMOState
ZIP Code64124ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Harry S Jonas MD
Director/Chairperson1.0XX000
Steven Israellite
Director/Vice Chairperson1.0XX000
Ralph C Johnson MS CPA
Director/Treasurer1.0XX000
Joseph L Hiersteiner
Director/Assistant Treasurer1.0XX000
Ursula Copeland MSW
Director/Secretary1.0XX000
Ruth Terrell
Director/Assistant Secretary1.0XX000
Farah Abdi
Director1.0X000
Charles Houseworth
Director1.0X000
Mona Lee Perry
Director1.0X000
Manuel Solano MD
Director1.0X000
Nhoung Tran
Director1.0X000
ROBERT BROOKS
Director1.0X000
JERRY STOLOV
Director1.0X000
Maime Hughes
Emeritus (Non-Voting Director)1.0X000
Hilda Fuentes
Chief Executive Officer40.0X165588015635
Ralph Caro
Chief Operating Officer40.0X128241014068
Daniel T Purdom MD
Chief Medical Officer40.0X164756014340
Harvey W Shaw Jr DDS
Chief Dental Officer40.0X114341010410
Helen K Darby RN
Chief Clinical Officer40.0X11196306575
Bob Theis CPA
Chief Financial Officer40.0X106912010752
Jack Edminsen MD
Psychiatrist40.016204302259X
Sudha Chaudhuri MD
Physician32.015765609184X
Cindy Ruttan MD
Psychiatrist32.0141602012243X
COLETTE FLEMING MD
Physician40.0133398010938X
ASHLEY FERRARO DO
Physician40.012972605015X
Charlene Mason-Dozier DDS
Former Chief Dental Officer40.0131071012832X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1647297TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation124251TotalOtherCompensation
Number Individuals GT100 K17NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonGC OF MISSOURI LLCNamePerson
FieldValueIRS element (for citing)
Address Of ContractorAddressOfContractor
Description Of ServicesCONSTRUCTIONDescriptionOfServices
Compensation196340Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Federated Campaigns101918FederatedCampaigns
Government Grants9449866GovernmentGrants
All Other Contributions852914AllOtherContributions
Noncash Contributions157250NoncashContributions
Total Contributions10404698TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code621400BusinessCode
Total Revenue Column6792838TotalRevenueColumn
Related Or Exempt Function Income6792838RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue6792838TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column20073TotalRevenueColumn
Exclusion$20,073ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities238299Securities
Other250Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities256034Securities
Other5057Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-17735Securities
Other-4807Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-22542TotalRevenueColumn
Exclusion-$22,542ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER INCOMEDescription
Business Code900099BusinessCode
Total Revenue Column86496TotalRevenueColumn
Exclusion$86,496ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue86496TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column17281563TotalRevenueColumn
Related Or Exempt Function Income6792838RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$84,027ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total681667Total
Program Services681667ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total905588Total
Program Services706540ProgramServices
Management And General199048ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6823607Total
Program Services5323855ProgramServices
Management And General1421258ManagementAndGeneral
Fundraising78494Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total215154Total
Program Services164758ProgramServices
Management And General48993ManagementAndGeneral
Fundraising1403Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1570705Total
Program Services1390190ProgramServices
Management And General180007ManagementAndGeneral
Fundraising508Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total647429Total
Program Services515837ProgramServices
Management And General120995ManagementAndGeneral
Fundraising10597Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total76379Total
Program Services37474ProgramServices
Management And General38905ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total144107Total
Program Services1125ProgramServices
Management And General142982ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total873687Total
Program Services666320ProgramServices
Management And General207367ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total146611Total
Program Services138369ProgramServices
Management And General8242ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1316989Total
Program Services1059518ProgramServices
Management And General257471ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total159072Total
Program Services143587ProgramServices
Management And General15485ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total456085Total
Program Services333674ProgramServices
Management And General122411ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total65218Total
Program Services52418ProgramServices
Management And General12800ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total16462Total
Program Services7555ProgramServices
Management And General8907ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total6176Total
Program Services5909ProgramServices
Management And General267ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total635729Total
Program Services431227ProgramServices
Management And General204502ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total61980Total
Program Services171ProgramServices
Management And General61809ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt Expense448072448072
Repairs & Maintenance1679169728470632
IMPAIRMENT LOSS385917385917
Dues & Subscriptions766643976336901
Education665415117415367

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total86850Total
Program Services26190ProgramServices
Management And General60660ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total16034605Total
Program Services12708594ProgramServices
Management And General3235009ManagementAndGeneral
Fundraising91002Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY133263BOY
EOY281452EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1078462BOY
EOY1533491EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY642166BOY
EOY525510EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY644279BOY
EOY551036EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY120738BOY
EOY113788EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY65547BOY
EOY112274EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis10392272LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7751924LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2604205BOY
EOY2640348EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY933446BOY
EOY1049439EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7530283BOY
EOY9229182EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY13752389BOY
EOY16036520EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY981059BOY
EOY1168263EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY160241BOY
EOY448806EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY134691BOY
EOY79087EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1275991BOY
EOY1696156EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5916318BOY
EOY7236432EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6560080BOY
EOY7103932EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12476398BOY
EOY14340364EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13752389BOY
EOY16036520EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis249466OtherCostOrOtherBasis
Book Value249466BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3885650OtherCostOrOtherBasis
Depreciation3542477Depreciation
Book Value343173BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis282810OtherCostOrOtherBasis
Depreciation89538Depreciation
Book Value193272BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis5644372OtherCostOrOtherBasis
Depreciation4119909Depreciation
Book Value1524463BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis329974OtherCostOrOtherBasis
Book Value329974BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2640348TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
EST AMTS DUE FROM 3RD PARTIES2075000
A/R- OTHER9156
SAMUEL U RODGERS LEGACY FUND41094
INT IN NET ASSETS OF SURHCF7103932
FieldValueIRS element (for citing)
Total Book Value Other Assets9229182TotalBookValueOtherAssets
Total Revenue17281563TotalRevenue
Total Expenses16034605TotalExpenses
Excess Or Deficit For Year1246958ExcessOrDeficitForYear
Net Unrealized GL On Investments73156NetUnrealizedGLOnInvestments
Total Adjustments73156TotalAdjustments
Excess Or Deficit Per FS1320114ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt17354719TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments73156NetUnrealizedGainsInvestments
Revenue Not Rptd F99073156RevenueNotRptdF990
Revenue Subtotal17281563RevenueSubtotal
Total Revenue Per Form99017281563TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16034605TotExpensesEtcAuditedFinclStmt
Expenses Subtotal16034605ExpensesSubtotal
Total Expenses Per Form99016034605TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
UNCERTAIN TAX POSITIONS DISCLOSURESCHEDULE D, PART X, LINE 2MANAGEMENT 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.
RECONCILIATION OF CHANGE IN NET ASSETSSCHEDULE D, PART XI, LINE 4UNREALIZED GAIN 73,156

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1SAMUEL U RODGERS HEALTH CENTER FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1825 EUCLID AVEAddressLine1
CityKANSAS CITYCity
StateMOState
ZIP Code64124ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient200751739EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant681667AmountOfCashGrant
Purpose Of GrantOPERATIONSPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCESS FOR MONITORING THE USE OF GRANTS IN THE U.S.Identifier
Return ReferenceSCHEDULE I, PART I, LINE 2ReturnReference
ExplanationSAMUEL U. RODGERS HEALTH CENTER GRANTED SAMUEL U. RODGERS HEALTH CENTER FOUNDATION THE MONIES TO BEGIN ITS OPERATIONS. THE FOUNDATION IS A TYPE 1, SUPPORTING ORGANIZATION OF THE HEALTH CENTER, THEREFORE THE HEALTH CENTER CONTROLS THE FOUNDATION.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Hilda Fuentes
16529200029608420072150181223000
Daniel T Purdom MD
16446000029608493058470179096000
Charlene Mason-Dozier DDS
13077500029606616062160143903000
Jack Edminsen MD
1619610008202259000164302000
Sudha Chaudhuri MD
15753100012505107040770166840000
Cindy Ruttan MD
14130600029606934053090153845000

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty
Securities Publicly TradedSecuritiesPubliclyTraded
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990157250NoncashContribsRptdF990
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CHANGES TO PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, LINE 3The Health Center no longer performs the case management of foster care children.
PROGRAM SERVICE ACCOMPLISHMENTFORM 990, PART III, LINE 4AThe Health Center is located in a community that is a vital part of the metropolitan area's multicultural fabric. Located northeast of the Vine District, the Health Center is accessible to neighborhood residents including individuals and families residing in nearby public housing family developments. Comprehensive care is delivered to people throughout the Kansas City metropolitan area and rural Lafayette county and surrounding area in Missouri. Our outpatient primary care services include: - Adult & Senior Services - Behavioral Health - Children's & Adolescents Health - Women's Health - Dental Health - Podiatry On-site ancillary and supportive services include: - Laboratory - Imaging - Radiology - Pharmacy - Interpreters - Patient Transportation A full range of outreach services complete the array of primary care services. They include: - Education and screening for breast and cervical cancer - Counseling and treatment for alcohol, tobacco and other drug abuse - WIC and nutrition education services (serving 3,200 individuals monthly) - Missouri HealthNet enrollment - Community outreach and health education Today's constantly changing health care system has added a special challenge to the Health Center's ability to care for the medically underserved people in our service area: - The Kansas City area is home to an increasing number of financially indigent and uninsured patients who are ineligible for public support programs; - Many of the Health Center's patients are medically uninsured while third party reimbursement remains flat. The Health Center's patient base is extraordinarily diverse. Because we are located near one of the largest refugee resettlement facilities in the Midwest, our Health Center is a point of entry to primary care services for immigrants from war-torn nations. More than twenty percent of the 1.8 million residents of the Kansas City metropolitan area are uninsured or are on Medicaid. Nearly one-third of our patients are best served in a language other than English. To ensure these patients receive high quality care, the Health Center employs a cadre of interpreters who speak 12 languages. Among patients served, 28 percent are Hispanic/Latino, 35 percent Caucasian, 22 percent African American, 9 percent representing other ethnicities and 6 percent are Asian/Pacific Islander. Children represent 37 percent of our patient base. Thus, protecting children from childhood diseases is a vital part of our mission. Unchecked, the ravages of childhood illnesses such as Measles, Mumps, and Rubella can cause permanent disability or even death. The Health Center is committed to providing high quality care that is culturally competent, whether patients live in a rural community, moved here from another country, or were raised in Kansas City's urban core. In the calendar year 2009, the Health Center served nearly 18,600 patients through almost 68,800 visits.
FORM 990 REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 11AAN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE 990 IS THEN PROVIDED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING THE 990. ANY QUESTIONS AND CONCERNS THE FINANCE COMMITTEE HAS ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL 990 WITH ALL REQUIRED SCHEDULES IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990.
CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CDuty to Disclose: If an Interested Person has a Position or Financial Interest in any business or other entity with which the Health Center is considering entering into an arrangement or transaction, the Interested Person must disclose the existence of the conflict to the Health Center's Board of Directors ("Board"). Determining Whether a Conflict of Interest Exists: The Board of Directors will make the determination. Procedures for Addressing the Conflict of Interest: - Prior to any discussion and vote on whether a conflict of interest exists, an Interested Person may make a presentation to the Board or the Executive Committee regarding the Interested Person's Position or Financial Interest. After such presentation, the Interested Person will leave the meeting during the discussion of, and the vote on, the Proposed Transaction. - The Board or the Executive Committee will undertake appropriate due diligence and inform itself of all material information reasonably available to it and explore all reasonable alternatives to the Proposed Transaction that would not involve the conflict of interest. - If a more advantageous transaction or arrangement is not reasonably possible under circumstances not producing a conflict of interest, the Board or the Executive Committee will determine by a majority vote of the Disinterested Directors whether the Proposed Transaction is (i) in the Health Center's best interest, (ii) for the Health Center's own benefit, and (iii) fair and reasonable to the Health Center. In conformity with this determination, the Board or the Executive Committee will make its decision as to whether the Health Center may enter into the Proposed Transaction. Violations of the Conflicts of Interest Policy: If the Board or the Executive Committee determines that the Covered Person has in fact failed to disclose a Position or a Financial Interest, the Board or the Executive Committee will take appropriate disciplinary and corrective action. Documentation in Minutes: With respect to the determination of whether a conflict of interest exists, the name of the Interested Person who disclosed or was otherwise found to have a Position or Financial Interest in connection with an actual or potential conflict of interest; the nature of the Position or Financial Interest; any action taken to determine whether a conflict of interest was present; and the Board or the Executive Committee's decision as to whether a conflict of interest in fact existed. Annual Statements: Each Covered Person will annually sign a statement that affirms such person: - Has received a copy of this Policy; - Has read and understands the Policy; - Has agreed to comply with the Policy; and - Understand the Health Center is exempt from federal income tax and to maintain its federal tax exemption the Health Center must engage primarily in activities that accomplish one or more of its tax-exempt purposes. In addition, each Covered Person will annually complete, sign and promptly return to the Board or the Executive Committee a Questionnaire and Disclosure Statement substantially in the form attached hereto. A Covered Person need not disclose Compensation paid to the Covered Person by Health Center pursuant to a resolution of the Board. Periodic Reviews: The periodic reviews as required by the policy will, at a minimum, include the following subjects: - Whether the Health Center Compensation arrangements are reasonable, based on competent survey information, and are the result of arm's-length bargaining; and - Whether transactions and arrangements with other entities and individuals conform to the Health Center's policies, are properly recorded, reflect reasonable payments for goods and services, further the Health Center's tax-exempt purposes and do not result in private inurnment, impermissible private benefit, or in an excess benefit transaction.
COMPENSATION REVIEWFORM 990, PART VI, SECTION B, LINE 15AThe last evaluation for the CEO was in 2009. This evaluation was done by the Health Center's Board of Directors. The Chairperson of the Board will lead the assessment process. The chair shall select a Performance and Compensation Committee and its chair. The CEO will complete a self-assessment. This allows the Board and CEO to compare one another's perception of the CEO's performance. The Chairperson of the Performance and Compensation Committee will have each board member complete the Assessment form individually and compile results. Distribution of the assessment form: The Committee Chairperson will distribute the CEO Self-Assessment and the Board's Assessment of the CEO well enough in advance to allow ample time for completion. The Committee Chairperson will set a deadline for completing the Board's Assessment of the CEO. Analysis of the results: The responses for each question will be added together and the average response computed. Next, the average responses for each question will be added together and the average response for the assessment as a whole should be calculated. The results will be shared with the Board for discussion and analysis in closed session. Review of the results with the CEO: The CEO and the Board will meet in a closed executive session or a special meeting to review and discuss the results. Based on the results, the Board and CEO will develop a written performance plan and performance goals for the CEO describing areas of focus and improvement for the next year. The performance assessment will be used as a basis for determining compensation. An independent committee, using comparability data will conduct compensation analysis. Such deliberations and decisions regarding compensation shall be documented and substantiated. This compensation review methodology shall be used for all Chief Officer Positions. Solicit the CEO's feedback: The Board will obtain the CEO's feedback regarding the assessment process. Feedback will include understanding the CEO's agreement or disagreement with the Board's assessment; whether the format was appropriate, whether the Board and the CEO believed that the form used captured all of the necessary elements, and which areas could be improved in the next assessment. Other officers and key employees: On a regular basis, human resources will conduct salary surveys to ensure current job pay ranges and median pay for certain benchmarked positions remain competitive in the marketplace and consistent with the company's compensation philosophy. An independent committee using comparability data will conduct compensation analysis. Such deliberations and decisions regarding compensation should be documented and substantiated.
AVAILABILITY OF DOCUMENTSFORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
AVERAGE HOURS WORKED FOR RELATED ORGANIZATIONFORM 990, PART VII, SECTION A, LINE 1A, COLUMN BAVG HOURS WORKED FOR RELATED ORG ----------------- HILDA FUENTES 1 RALPH CARO 1 HARRY S. JONAS, M.D. 1 RALPH C. JOHNSON, MS, CPA 1 MANUEL SOLANO, M.D. 1

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Samuel U Rodgers Health Ctr FoundationBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1825 Euclid AvenueAddressLine1
CityKansas CityCity
StateMOState
ZIP Code64124ZIPCode
FieldValueIRS element (for citing)
EIN200751739EIN
Primary ActivitiesSUPPORT ORGPrimaryActivities
Legal Domicile StateMOLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status11APublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Samuel U Rodgers Health Center FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeBTransactionType
Amount Involved681667AmountInvolved

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