2011-08-03T09:19:36-05:00 2010-09-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2009-10-01 430899356 Samuel U Rodgers Health Center Inc SAMU 8164744920 825 Euclid Avenue Kansas City MO 64124 HILDA FUENTES 2011-07-01 true Michael J Engle 8162216300 2009 2016-02-24 21:20:13Z Hilda Fuentes 825 Euclid Avenue Kansas City MO 64124 17542654 false X www.rodgershealth.org X 1968 MO THE CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE FOR ALL. 12 12 268 25 0 0 9736155 10404698 6311386 6792838 3697 -2469 98781 86496 16150019 17281563 913533 681667 0 0 10437380 10162483 0 0 91002 4144012 5190455 15494925 16034605 655094 1246958 13752389 16036520 1275991 1696156 12476398 14340364 THE CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE FOR ALL. false true 12708594 681667 6792838 SEE SCHEDULE O 12708594 true true false false false false false false false true true false false false false false false false false false false true false true false false false false false false false false true false false false false true true false false true 20 0 true 268 true false false false false false false false false false 12 12 false false false false false false false true true false false true true true true true true true true false MO X BOB THEIS 8168894802 825 EUCLID AVENUE Kansas City MO 64124 Harry S Jonas MD 1.0 X X 0 0 0 Steven Israellite 1.0 X X 0 0 0 Ralph C Johnson MS CPA 1.0 X X 0 0 0 Joseph L Hiersteiner 1.0 X X 0 0 0 Ursula Copeland MSW 1.0 X X 0 0 0 Ruth Terrell 1.0 X X 0 0 0 Farah Abdi 1.0 X 0 0 0 Charles Houseworth 1.0 X 0 0 0 Mona Lee Perry 1.0 X 0 0 0 Manuel Solano MD 1.0 X 0 0 0 Nhoung Tran 1.0 X 0 0 0 ROBERT BROOKS 1.0 X 0 0 0 JERRY STOLOV 1.0 X 0 0 0 Maime Hughes 1.0 X 0 0 0 Hilda Fuentes 40.0 X 165588 0 15635 Ralph Caro 40.0 X 128241 0 14068 Daniel T Purdom MD 40.0 X 164756 0 14340 Harvey W Shaw Jr DDS 40.0 X 114341 0 10410 Helen K Darby RN 40.0 X 111963 0 6575 Bob Theis CPA 40.0 X 106912 0 10752 Jack Edminsen MD 40.0 X 162043 0 2259 Sudha Chaudhuri MD 32.0 X 157656 0 9184 Cindy Ruttan MD 32.0 X 141602 0 12243 COLETTE FLEMING MD 40.0 X 133398 0 10938 ASHLEY FERRARO DO 40.0 X 129726 0 5015 Charlene Mason-Dozier DDS 40.0 X 131071 0 12832 1647297 0 124251 17 true true false GC OF MISSOURI LLC CONSTRUCTION 196340 1 101918 9449866 852914 157250 10404698 NET PATIENT SERVICE REVENUE 621400 6792838 6792838 6792838 20073 20073 0 0 238299 250 256034 5057 -17735 -4807 -22542 -22542 0 0 0 OTHER INCOME 900099 86496 86496 86496 17281563 6792838 0 84027 681667 681667 0 0 0 905588 706540 199048 0 6823607 5323855 1421258 78494 215154 164758 48993 1403 1570705 1390190 180007 508 647429 515837 120995 10597 0 76379 37474 38905 144107 1125 142982 0 0 0 873687 666320 207367 146611 138369 8242 1316989 1059518 257471 159072 143587 15485 0 456085 333674 122411 65218 52418 12800 0 16462 7555 8907 6176 5909 267 0 635729 431227 204502 61980 171 61809 Bad Debt Expense 448072 448072 Repairs & Maintenance 167916 97284 70632 IMPAIRMENT LOSS 385917 385917 Dues & Subscriptions 76664 39763 36901 Education 66541 51174 15367 86850 26190 60660 16034605 12708594 3235009 91002 133263 281452 1078462 1533491 642166 525510 644279 551036 120738 113788 65547 112274 10392272 7751924 2604205 2640348 933446 1049439 7530283 9229182 13752389 16036520 981059 1168263 160241 448806 134691 79087 1275991 1696156 X 5916318 7236432 6560080 7103932 12476398 14340364 13752389 16036520 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 249466 249466 3885650 3542477 343173 282810 89538 193272 5644372 4119909 1524463 329974 329974 2640348 EST AMTS DUE FROM 3RD PARTIES 2075000 A/R- OTHER 9156 SAMUEL U RODGERS LEGACY FUND 41094 INT IN NET ASSETS OF SURHCF 7103932 9229182 17281563 16034605 1246958 73156 73156 1320114 17354719 73156 73156 17281563 17281563 16034605 16034605 16034605 UNCERTAIN TAX POSITIONS DISCLOSURE 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. RECONCILIATION OF CHANGE IN NET ASSETS SCHEDULE D, PART XI, LINE 4 UNREALIZED GAIN 73,156 true SAMUEL U RODGERS HEALTH CENTER FOUNDATION 825 EUCLID AVE KANSAS CITY MO 64124 200751739 501(C)(3) 681667 OPERATIONS 1 0 PROCESS FOR MONITORING THE USE OF GRANTS IN THE U.S. SCHEDULE I, PART I, LINE 2 SAMUEL 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. X X X X false false false false false false false false false Hilda Fuentes 165292 0 0 0 296 0 8420 0 7215 0 181223 0 0 0 Daniel T Purdom MD 164460 0 0 0 296 0 8493 0 5847 0 179096 0 0 0 Charlene Mason-Dozier DDS 130775 0 0 0 296 0 6616 0 6216 0 143903 0 0 0 Jack Edminsen MD 161961 0 0 0 82 0 2259 0 0 0 164302 0 0 0 Sudha Chaudhuri MD 157531 0 0 0 125 0 5107 0 4077 0 166840 0 0 0 Cindy Ruttan MD 141306 0 0 0 296 0 6934 0 5309 0 153845 0 0 0 X 1 157250 COST false true false CHANGES TO PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 3 The Health Center no longer performs the case management of foster care children. PROGRAM SERVICE ACCOMPLISHMENT FORM 990, PART III, LINE 4A The 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 PROCESS FORM 990, PART VI, SECTION B, LINE 11A AN 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 POLICY FORM 990, PART VI, SECTION B, LINE 12C Duty 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 REVIEW FORM 990, PART VI, SECTION B, LINE 15A The 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 DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. AVERAGE HOURS WORKED FOR RELATED ORGANIZATION FORM 990, PART VII, SECTION A, LINE 1A, COLUMN B AVG 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 Samuel U Rodgers Health Ctr Foundation 825 Euclid Avenue Kansas City MO 64124 200751739 SUPPORT ORG MO 501(c)(3) 11A NA false true false false false false false false false false true false true true false false true false Samuel U Rodgers Health Center Foundation B 681667