KENOSHA COMMUNITY HEALTH CENTER INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- KENOSHA COMMUNITY HEALTH CENTER INC (EIN 39-1789874)
- Tax period
- 2010-03-01 to 2011-02-28
- Filed
- 2011-07-15
- IRS object ID
- 201121969349300012
- Schema version
- 2010v3.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-07-15T12:46:24-05:00 | Timestamp |
| Tax Period End Date | 2011-02-28 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTON GUNDERSON LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 1347 | AddressLine1 |
| City | RACINE | City |
| State | WI | State |
| ZIP Code | 534011347 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-03-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391789874 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENOSHA COMMUNITY HEALTH CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | KENO | NameControl |
| Phone | 2626560044 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 57TH STREET SUITE 700 | AddressLine1 |
| City | KENOSHA | City |
| State | WI | State |
| ZIP Code | 53140 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JACK WATERS | Name |
| Title | OFFICER | Title |
| Phone | 2626560044 | Phone |
| Date Signed | 2011-07-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN D KARLS CPA | Name |
| Phone | 2626379351 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 57TH STREET SUITE 700 | AddressLine1 |
| City | KENOSHA | City |
| State | WI | State |
| ZIP Code | 53140 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 7965800 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.KENOSHACHC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE QUALITY, LOW-COST HEALTH AND DENTAL CARE TO THE UNDERSERVED AND UNINSURED PEOPLE IN KENOSHA, WI. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 142 | TotalNbrEmployees |
| Total Nbr Volunteers | 11 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1793227 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1397441 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4772588 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6552819 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3671 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1461 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 7268 | OtherRevenuePriorYear |
| Other Revenue Current Year | 14079 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6576754 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7965800 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 15245 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1476 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4076000 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5541633 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2113359 | OtherExpensePriorYear |
| Other Expenses Current Year | 2312515 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6204604 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7855624 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 372150 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 110176 | RevenuesLessExpensesCY |
| Total Assets BOY | 7379538 | TotalAssetsBOY |
| Total Assets EOY | 7462700 | TotalAssetsEOY |
| Total Liabilities BOY | 3605425 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3578411 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3774113 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3884289 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE QUALITY, LOW-COST HEALTH AND DENTAL CARE TO THE UNDERSERVED AND UNINSURED PEOPLE IN KENOSHA, WI. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1864867 | Expense |
| Grants | 1476 | Grants |
| Revenue | 2302830 | Revenue |
| Description | TO PROVIDE QUALITY, LOW-COST HEALTH CARE TO THE UNDERSERVED AND UNINSURED PEOPLE IN KENOSHA, WI | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3830334 | Expense |
| Revenue | 4264068 | Revenue |
| Description | TO PROVIDE QUALITY, LOW-COST DENTAL CARE TO THE UNDERSERVED AND UNINSURED PEOPLE IN EKNOSHA, WI | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 5695201 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 9 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 142 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID HUGHES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2626560044 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4536 22ND AVENUE | AddressLine1 |
| City | KENOSHA | City |
| State | WI | State |
| ZIP Code | 53140 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| FRANK LUDOWISE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM ROBERTS | |||||||
| PRESIDENT | 1.00 | X | 0 | 0 | 0 | X | |
| JACKIE BUSH | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | |
| CINDY JOHNSON | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JO AN WYNN | |||||||
| VICE PRESIDENT | 1.00 | X | 0 | 0 | 0 | X | |
| PAM HALBACH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| LATASHA JONES | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JAY A CASHMORE | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X | |
| KELLY WILKS | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JACK WATERS | |||||||
| EXECUTIVE DIRECTOR | 40.00 | 133937 | 0 | 7207 | X | ||
| BETH DEN BOER | |||||||
| CHIEF OPERATING OFFICER | 40.00 | 99676 | 0 | 21166 | X | ||
| DAVID HUGHES | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 134543 | 0 | 15278 | X | ||
| ALESSANDRO SAVAGLIO JR | |||||||
| DENTIST | 40.00 | 175104 | 0 | 8729 | X | ||
| PRZEMYSLAW KOLANKO | |||||||
| PHYSICIAN | 40.00 | 138392 | 0 | 18955 | X | ||
| ELZBIETA KOSLACZ-KOLANKO | |||||||
| PHYSICIAN | 40.00 | 130298 | 0 | 8137 | X | ||
| RACHAEL SCHUTTE | |||||||
| PHYSICIAN | 40.00 | 130027 | 0 | 1671 | X | ||
| UMAIR SHARIH | |||||||
| PHYSICIAN | 40.00 | 158458 | 0 | 13590 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1100435 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 94733 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Government Grants | 1384020 | GovernmentGrants |
| All Other Contributions | 13421 | AllOtherContributions |
| Total Contributions | 1397441 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE FEES | 621110 | 6511288 | 6511288 |
| CONSULTING REVENUE | 621110 | 41531 | 41531 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6552819 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1461 | TotalRevenueColumn |
| Exclusion | $1,461 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 14079 | TotalRevenueColumn |
| Related Or Exempt Function Income | 14079 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 14079 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7965800 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6566898 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,461 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1476 | Total |
| Program Services | 1476 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4618965 | Total |
| Program Services | 3408226 | ProgramServices |
| Management And General | 1210739 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 544941 | Total |
| Program Services | 377100 | ProgramServices |
| Management And General | 167841 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 377727 | Total |
| Program Services | 274016 | ProgramServices |
| Management And General | 103711 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8099 | Total |
| Program Services | 5102 | ProgramServices |
| Management And General | 2997 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26164 | Total |
| Program Services | 5180 | ProgramServices |
| Management And General | 20984 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 377913 | Total |
| Program Services | 112207 | ProgramServices |
| Management And General | 265706 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 772 | Total |
| Program Services | 772 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 197975 | Total |
| Program Services | 147243 | ProgramServices |
| Management And General | 50732 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26792 | Total |
| Program Services | 5135 | ProgramServices |
| Management And General | 21657 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18971 | Total |
| Program Services | 3789 | ProgramServices |
| Management And General | 15182 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 145476 | Total |
| Management And General | 145476 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 313480 | Total |
| Program Services | 287056 | ProgramServices |
| Management And General | 26424 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21563 | Total |
| Program Services | 22476 | ProgramServices |
| Management And General | -913 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 599888 | 563521 | 36367 |
| REPAIRS AND MAINTENANCE | 253058 | 204630 | 48428 |
| LAB FEES | 140311 | 140311 | |
| BAD DEBT EXPENSE | 47742 | 47742 | |
| TELEPHONE | 45479 | 33339 | 12140 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88832 | Total |
| Program Services | 55880 | ProgramServices |
| Management And General | 32952 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7855624 | Total |
| Program Services | 5695201 | ProgramServices |
| Management And General | 2160423 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48003 | BOY |
| EOY | 16327 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1276196 | BOY |
| EOY | 976920 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 254028 | BOY |
| EOY | 95942 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 950126 | BOY |
| EOY | 1381533 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4882 | BOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32896 | BOY |
| EOY | 95712 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 5897298 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1001032 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4813407 | BOY |
| EOY | 4896266 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7379538 | BOY |
| EOY | 7462700 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 574511 | BOY |
| EOY | 562263 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30914 | BOY |
| EOY | 16148 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3000000 | BOY |
| EOY | 3000000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3605425 | BOY |
| EOY | 3578411 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3774113 | BOY |
| EOY | 3884289 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3774113 | BOY |
| EOY | 3884289 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7379538 | BOY |
| EOY | 7462700 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 110176 | ReconcilationRevenueExpenses |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 159200 | OtherCostOrOtherBasis |
| Book Value | 159200 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3690002 | OtherCostOrOtherBasis |
| Depreciation | 296983 | Depreciation |
| Book Value | 3393019 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 724283 | OtherCostOrOtherBasis |
| Depreciation | 147473 | Depreciation |
| Book Value | 576810 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1068995 | OtherCostOrOtherBasis |
| Depreciation | 471292 | Depreciation |
| Book Value | 597703 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 254818 | OtherCostOrOtherBasis |
| Depreciation | 85284 | Depreciation |
| Book Value | 169534 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4896266 | TotalOfBookValueLandBuildings |
| Total Revenue | 7965800 | TotalRevenue |
| Total Expenses | 7855624 | TotalExpenses |
| Excess Or Deficit For Year | 110176 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 110176 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 7965800 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 7965800 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 7965800 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7855624 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 7855624 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 7855624 | TotalExpensesPerForm990 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALESSANDRO SAVAGLIO JR | |||||||||||||
| 175104 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 175104 | 0 | 0 | 0 |
| PRZEMYSLAW KOLANKO | |||||||||||||
| 138392 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 138392 | 0 | 0 | 0 |
| UMAIR SHARIH | |||||||||||||
| 158458 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 158458 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 4B | ReturnReference |
| Explanation | PRZEMYSLAW KOLANKO - $3,000 ELZBIETA KOSLACZ-KOLANKO - $2,800 JACK WATERS - $3,946 BETH DENBOER - 3,717 | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM IS REVIEWED BY THE BOARD FINANCE COMMITTEE BEFORE IT IS FILED. | |
| THE ORGANIZATION REQUIRES ALL NEW BOARD MEMBERS TO SIGN A CONFLICT OF INTEREST STATEMENT. BOARD MEMBERS ARE REQUIRED TO UPDATE THESE STATEMENTS ANNUALLY. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE ORGANIZATION USES A VARIETY OF REGIONAL AND EXECUTIVE RECRUITING FIRMS FOR KEY EMPLOYEES WHO RECOMMEND COMPENSATION PACKAGES BASED ON MARKET DATA. THE ORGANIZATION ALSO PARTICIPATES IN A VARIETY OF COMPENSATION SURVEYS THROUGH NACHC, WPHCA, AND GENERALIST HR ORGANIZATIONS AND RECEIVE THOSE REPORTS. THERE ARE ALSO PERIODIC SPOT CHECKS LOCALLY FOR SPECIFIC POSITIONS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| UPON REQUEST | FORM 990, PART VI, SECTION C, LINE 19 | |
| THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XI, LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENOSHA COMMUNITY HEALTH CENTER LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4536 22ND AVENUE | AddressLine1 |
| City | KENOSHA | City |
| State | WI | State |
| ZIP Code | 53140 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391789874 | EIN |
| Primary Activities | REAL ESTATE HOLDING | PrimaryActivities |
| Legal Domicile State | WI | LegalDomicileState |
| Total Income | -4775 | TotalIncome |
| EOY Assets | 3617455 | EOYAssets |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |