2011-01-17T10:21:20-06:00 2010-02-28 SEIM JOHNSON SESTAK & QUIST LLP 8807 INDIAN HILLS DRIVE SUITE 300 OMAHA NE 681144123 990 2009-03-01 470548990 ONEWORLD COMMUNITY HEALTH CENTER INC ONEW 4025028858 4920 SOUTH 30TH STREET No 103 OMAHA NE 68107 ANDREA SKOLKIN 4025028858 2011-01-17 1 Barbara J Fajen 4023302660 2009 2016-02-24 21:20:13Z ANDREA SKOLKIN 4920 SOUTH 30TH STREET No 103 OMAHA NE 68107 14848763 0 X WWW.ONEWORLDOMAHA.ORG X 1975 NE The most significant activities involve providing primary medical care, dental and behavioral services to groups of all ages surrounding the Omaha area. OneWorld also has an in-house pharmacy to provide the patients with easy accessibility to prescription medication. 18 18 205 30 0 0 6854363 8485881 6390594 5888883 93379 175630 101121 84651 13439457 14635045 61929 68702 0 5906994 7304902 0 0 6391534 6922404 12360457 14296008 1079000 339037 9182931 10167450 957689 1378745 8225242 8788705 OneWorld Community Health Centers, in partnership with the community, provide culturally respectful, quality healthcare to the underserved. 1 0 10422440 68702 3268532 Medical Clinic - to provide health care services to underserved individuals in the Omaha and Plattsmouth areas. For this this current year, OneWorld provided 55,751 encounters to 15,675 patients. 684246 681623 Ongoing WIC subcontract with Douglas County Health Department to provide infant and children nutrition services. The number of encounters provided were 47,169. 1580161 1488382 The dental department grew to accomodate increased demand for dental services. Total encounters provided were 8,539 to 4,206 patients. 491876 450346 The integrated model for behavioral services was expanded to accomodate the increased demand. Total encounters provided were 7,884 to 3,796 patients. 491876 450346 13178723 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 12 0 1 205 1 0 0 0 0 0 0 0 0 0 18 18 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 Jean Flott 5.00 X X 0 0 0 Paul Esposito 5.00 X X 0 0 0 Gabe Romero 5.00 X X 0 0 0 Anna Davis 5.00 X X 0 0 0 Brent Blume 3.00 X 0 0 0 Guadalupe Camacho 3.00 X 0 0 0 Donovan Hutchens 3.00 X 0 0 0 Jennifer Jones 3.00 X 0 0 0 Andrew Kloeckner 3.00 X 0 0 0 Blanca Mejia 3.00 X 0 0 0 Heath Mello 3.00 X 0 0 0 Juan Montero 3.00 X 0 0 0 Jeremy Norquist 3.00 X 0 0 0 Dave Ridder 3.00 X 0 0 0 Marisela Rincon 3.00 X 0 0 0 Concepcion Tinoco 3.00 X 0 0 0 Dustin Zabokrtsky 3.00 X 0 0 0 Marcy Zauha 3.00 X 0 0 0 Andrea Skolkin 40.00 X 153117 0 17518 Joel Dougherty 40.00 X 93020 0 9298 Carolina Apicella 40.00 X 87805 0 8611 Henry Dethlefs IV 40.00 X 151889 0 18366 Therese Hennessy 30.00 X 123461 0 11217 Paul Beutler 40.00 X 102649 0 9580 711941 0 74590 4 0 1 0 NuStyle Holdings 13057 W Center Rd Omaha NE 68144 Landlord 336166 UNMC Dept of Family Medicine 983075 Nebraska Medical Center omaha NE 68198 MEDICAL SERVICES 334167 Lund Ross Constructors 112 N 13th St Omaha NE 68102 Construction 318415 CUSTOM COMPUTING 11135 Mill Valley Rd Omaha NE 68154 BILLING SERVICES 256164 HOPE MEDICAL OUTREACH COALITION 4920 S 30TH STREET SUITE 105 Omaha NE 68107 MEDICAL SERVICES 254292 10 303404 37000 4518177 3627300 2100136 8485881 MEDICAL CLINIC 621990 4575487 4575487 DENTAL 621990 709972 709972 PHARMACY 446110 407691 407691 OTHER REVENUE 621990 156907 156907 BEHAVIORAL HEALTH PROG 621990 38826 38826 5888883 73802 73802 73855 73855 73855 73855 274784 172956 101828 101828 101828 51558 37000 40762 10796 10796 14635045 5888883 0 260281 68702 68702 369369 369369 5731194 5549383 181811 146448 141319 5129 562646 507262 55384 495245 455354 39891 10786 10786 51451 51451 10313 10313 996802 866383 130419 121026 119368 1658 2709579 2603608 105971 70966 56624 14342 591020 591020 40335 32112 8223 54443 36071 18372 743739 664060 79679 27796 27796 BAD DEBT EXPENSE 768876 768876 PHARMACY 502028 502028 LABORATORY 122437 122437 DUES, BOOKS, & SUBSCRIP 52402 19946 32456 LICENSES & FEES 47706 46374 1332 699 699 14296008 13178723 1117285 0 1597 2759 4108040 4736358 856758 953374 624096 516784 473644 155414 14880 104138 60184 212245 4589339 2628860 1893774 1960479 1062514 1438455 87444 87444 9182931 10167450 466740 771747 490949 606998 957689 1378745 X 7262422 8087139 962820 701566 8225242 8788705 9182931 10167450 X 0 1 1 X 1 1 X 4883531 3313020 6559701 6854363 8485881 30096496 4883531 3313020 6559701 6854363 8485881 30096496 60572 30035924 19086 98151 187627 172367 147657 624888 30721384 24791843 0.97770 0.94550 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1470415 509659 960756 2485314 1855922 629392 633610 263279 370331 1960479 14635045 14296008 339037 224426 224426 563463 15296105 224426 395872 40762 661060 14635045 0 14635045 14732642 395872 40762 436634 14296008 0 14296008 Part X: Description of Uncertain Tax Positions Under FIN 48: OneWorld is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. OneWorld adopted FASB ASC Topic 740 Subtopic 10 Section 25, Accounting for Uncertainty in Income Taxes - an interpretation of FASB ASC 740 during 2009. Section 25 provides specific guidance on how to address uncertainty in accounting for income tax assets and liabilities, prescribing recognition thresholds and measurement attributes. The adoption of Section 25 did not have a material impact on the financial position, results of operations and changes in net assets, or cash flow. Part XII, Line 2d - Other Adjustments: FUNDRAISING EVENT MILAGRO DINNER EXPENSE: 40762. Part XIII, Line 2d - Other Adjustments: FUNDRAISING EVENT MILAGRO DINNER EXPENSE: 40762. DINNER 71542 26000 45542 500 9780 29707 SOFTBALL 17016 11000 6016 775 88558 37000 51558 500 9780 30482 40762 10796 1 Prescriptions medication for the homeless population 100 25000 faIR MARKET VALUE Prescriptions and durable goods Prescriptions medication for the homeless population 80 30000 faIR MARKET VALUE Prescriptions Prescriptions medication for patients under the 200% poverty line 45 13702 faIR MARKET VALUE Medical Care & Prescription medication 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 138647 0 11400 0 3070 0 6094 0 11424 0 170635 0 0 0 Henry Dethlefs IV 151889 0 0 0 0 0 7187 0 11179 0 170255 0 0 0 Part I, Line 6 The CHIEF EXECUTIVE OFFICER RECEIVED A BONUS FOR 2009 THAT WAS CONTINGENT ON THE FOLLOWING 5 FACTORS EQUALLY: 1. EMPLOYEE AND PATIENT SATISFACTION NOT TO SCORE BELOW 4 ON A SCALE OF 1 TO 5. 2. THE ORGANIZATION'S OPERATING MARGIN BASED ON AUDIT FIGURES FROM 2% EARNING A FULL BONUS AT 4%. 3. UNQUALIFIED AUDIT OPINION WITH NO MATERIAL NON-COMPLIANCE. 4. THE IMPLEMENTATION OF ELECTRONIC MEDICAL RECORD ON A TIMELY BASIS WITH MINIMAL EFFECT ON PRODUCTIVITY. 5. SUCCESSFUL HIRING OF A DIRECTOR OF DEVELOPMENT. X 3 2100136 FAIR MARKET VALUE 0 1 0 Form 990, Part III, line 2 New Program Services In January of 2010, OneWorld Community Health Centers acquired HOPE pharmacy. 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, PAGE 11, PART XI, LINE 2C: COMMITTEE WITH OVERSIGHT OF THE AUDIT 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 community 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