2011-09-15T11:10:45-05:00 2011-01-31 WIPFLI LLP 43A W DAVENPORT ST RHINELANDER WI 54501 990 2010-02-01 391550213 NORTHERN HEALTH CENTERS INC NORT 7152766321 PO BOX 179 LAKEWOOD WI 54138 LAURA WALDVOGEL 7152766321 2011-09-14 1 RANDALL H BEARD CPA 7153691040 2011-09-14 2010 2016-03-07 17:11:31Z LAURA WALDVOGEL PO BOX 179 LAKEWOOD WI 54138 3715633 0 X WWW.NHCMEDDEN.COM X 1986 WI TO IMPROVE OUR COMMUNITY HEALTH BY PROVIDING ALL PERSONS QUALITY HEALTH CARE SERVICES. 10 10 48 15 0 0 1028394 1168946 1688029 2500628 3903 502 10593 43396 2730919 3713472 0 0 0 0 1708680 2112597 0 0 0 929293 1104952 2637973 3217549 92946 495923 1725615 2806806 467848 1053116 1257767 1753690 TO IMPROVE OUR COMMUNITY HEALTH BY PROVIDING ALL PERSONS A COMPREHENSIVE PROGRAM OF QUALITY FAMILY ORIENTED PRIMARY HEALTH CARE SERVICES REGARDLESS OF THEIR ABILITY TO PAY. 0 0 2307801 2500628 NORTHERN HEALTH CENTERS, INC. IS A FEDERALLY QUALIFIED HEALTH CENTER. AS SUCH, WE ARE AN ENTITY THAT SERVES A MEDICALLY UNDERSERVED POPULATION PROVIDING PRIMARY AND PREVENTATIVE MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE SERVICES. IN 2010 OVER 21% OF OUR TOTAL PATIENTS WERE UNINSURED AND ACCESSED OUR SLIDING FEE SCALE. NHC ALSO EXPANDED ACCESS TO PREVENTIVE DENTAL SERVICES FOR CHILDREN BY ADDING SEAL A SMILE PROGRAMMING IN THE SCHOOL SETTING IN OVER 15 SCHOOLS IN TWO COUNTIES. THE VAST MAJORITY OF NHC PATIENTS LIVE IN POVERTY. IN 2010 WE ALSO COMPLETED A MAJOR ADDITION AND RENOVATION PROJECT FUNDED WITH A HRSA CAPITAL IMPROVEMENT GRANT. THIS PROJECT ALLOWED US TO ADD THREE ADDITIONAL DENTAL OPERATORIES AND A LARGE PATIENT WAITING AREA WHILE ALSO ENHANCING OUR HANDICAP ACCESSIBILITY. 2307801 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 11 0 48 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X LAURAL WALDVOGEL 7152766321 15397 HWY 32 LAKEWOOD WI 54138 TED BARTELS 1.00 X 0 0 0 BETTY MACINTOSH 1.00 X 0 0 0 GARY DONALDSON 1.00 X 0 0 0 BETH HARTMAN 1.00 X 0 0 0 MIKE HESS 1.00 X 0 0 0 DEBBIE KRUGER 1.00 X X 0 0 0 KATHY RANK 1.00 X X 0 0 0 CHRIS BERRY 1.00 X 0 0 0 PAAL HANSEN 1.00 X 0 0 0 GAIL NELSON 1.00 X 0 0 0 LAURA WALDVOGEL 41.00 X 96584 0 4726 TED JUNG 40.00 X 132883 0 0 JAMES WALLACE 40.00 X 162776 0 0 JOE WINEGAR 40.00 X 118596 0 0 414255 0 0 3 0 1 0 MIRON CONSTRUCTION PO BOX 23910 GREEN BAY WI 543053910 CONSTRUCTION, GENERAL CONTRACTOR 391923 ADVANTAGE PURCHASING PO BOX 509 NEENAH WI 549570509 CONSTRUCTION, MATERIALS 121680 2 1114858 54088 1168946 MEDICAL & DENTAL SERVI 621110 1453515 1453515 FQHC REIMBURSEMENTS 621110 1047113 1047113 2500628 502 502 11818 2161 9657 9657 INSURANCE DISTRIBUTION 900099 32821 32821 MISCELLANEOUS 900099 918 918 33739 3713472 2534367 0 10159 96584 96584 1648675 1271562 377113 367338 267635 99703 9727 9727 56275 56275 18711 18711 342618 275024 67594 51206 51206 33641 33641 26154 23930 2224 13311 8815 4496 16853 5887 10966 21230 21230 99713 89742 9971 31491 31491 MEDICAL & DENTAL SUPPLI 164268 164268 BAD DEBT EXPENSE 104631 104631 REPAIRS AND MAINTENANCE 79264 78313 951 TELEPHONE 11977 8592 3385 PUBLICATIONS / SUBSCRIP 7974 4725 3249 15908 4677 11231 3217549 2307801 909748 0 49846 24993 5787 5817 334053 842371 157134 200222 35609 55964 8773 23364 2424279 770204 1134413 1654075 1725615 2806806 307319 246734 160529 785532 0 20850 467848 1053116 X 1257767 1753690 1257767 1753690 1725615 2806806 495923 0 X X 0 1 1 X 1 1 X 518318 611249 622584 1028394 1168946 3949491 518318 611249 622584 1028394 1168946 3949491 3949491 7574 4058 3422 3883 502 19439 4957 -4761 5203 10613 43396 59408 4028338 9061488 0.98040 0.98840 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3650 84294 87944 861149 277635 583514 659355 36264 623091 815831 456305 359526 1654075 CAPITAL LEASE OBLIGATIONS 20850 20850 3713472 3217549 495923 0 495923 3713472 0 3713472 0 3713472 3217549 0 3217549 0 3217549 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS A NON-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM STATE INCOME TAXES. THE ORGANIZATION ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OR THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. FEDERAL RETURNS FOR THE YEARS ENDED 2008 AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS. X 0 0 0 0 0 0 0 0 0 JAMES WALLACE 149022 0 12500 0 1254 0 0 0 0 0 162776 0 0 0 GARY DONALDSON NICOLET PHARMACY BOARD OF DIRECTOR 14056 340B PHARMACY 0 FORM 990, PART VI, SECTION B, LINE 11 A COPY WAS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. THE AUDITING FIRM ALSO PRESENTED COMPREHENSIVE AUDIT INFORMATION DIRECTLY TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C BOTH STAFF AND BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT IDENTIFYING ANY CONFLICTS ON AN ANNUAL BASIS. STAFF HAS RECEIVED REQUIRED TRAINING ON THE POLICY AND IT IS MONITORED ON A MONTHLY BASIS. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST AND ADDRESSING ANY ISSUES AS A RESULT OF THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY PERFORMANCE COUPLED WITH PREVAILING INDUSTRY STANDARDS AND THE CURRENT NACHC COMPENSATION REPORT. FORM 990, PART VI, SECTION C, LINE 19 ALL STAFF AND BOARD OF DIRECTORS MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. STAFF RECEIVES REQUIRED TRAINING UPON HIRE AND AT LEAST ANNUALLY THEREAFTER. THERE ARE ESTABLISHED POLICIES FOR REPORTING AND RESPONDING TO VIOLATIONS OF THE CONFLICT OF INTEREST POLICY WHICH IS PART OF THE LARGER NHC CORPORATE COMPLIANT POLICY. NHCS CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST AND FOLLOWING ESTABLISHED POLICY TO ADDRESS AND REPORTS OF VIOLATIONS. FORM 990, PART XII, LINE 2C: AN RFP PROCESS IS UTILIZED FOR THE SELECTION OF AUDITING FIRM. THE BOD AS A WHOLE APPROVES THE SELECTION OF THE AUDITING FIRM. THE FINANCE COMMITTEE AND BOD AS A WHOLE IS RESPONSIBLE FOR THE OVERSIGHT AND APPROVAL OF THE ANNUAL AUDIT.