2024-09-30T17:41:28+00:00 2024-01-31 440160260 Forvis Mazars LLP 910 E St Louis 200 PO Box 1190 Springfield MO 658062523 990 2023-02-01 421374894 Siouxland Community Health Center SIOU 7122522477 1021 NEBRASKA ST SIOUX CITY IA 51105 JAN ANDERSON CHIEF FINANCIAL OFFICER 7122522477 2024-09-30 true Krystal Creach P01248198 4178658701 2024-09-30 2023 2024-10-15 13:58:12Z ANDREA BUCKLEY 1021 NEBRASKA ST SIOUX CITY IA 51105 54528893 false X WWW.SLANDCHC.COM X 1991 IA TO BE A PATIENT-CENTERED MEDICAL HOME WHICH IMPROVES THE PHYSICAL, DENTAL, AND BEHAVIORAL HEALTH OF THE SIOUXLAND COMMUNITY WHILE ELIMINATING ACCESS BARRIERS. 16 16 405 18 0 0 12399042 12391747 34496617 41008827 329971 952122 209028 66360 47434658 54419056 216528 258118 0 25870120 28206028 0 0 0 14925806 17388734 41012454 45852880 6422204 8566176 48304504 56997169 5715475 5816785 42589029 51180384 INSPIRING AND EMPOWERING OUR COMMUNITY THROUGH HEALTH EQUITY FOR ALL. false false 24168013 258118 28627769 PRIMARY AND SPECIALTY MEDICAL SERVICES FOR FYE 2024: SCHC PROVIDED MEDICAL, PRENATAL, AND BEHAVIORAL HEALTH SERVICES FOR 88,433 PATIENT VISITS. SERVICES WERE PROVIDED BY SIX PRIMARY CARE PHYSICIANS, SIX PHYSICIAN ASSISTANTS, AND TWENTY-TWO NURSE PRACTITIONERS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 6821677 0 8043717 PHARMACY: THE SCHC PHARMACY IS AVAILABLE TO ALL PATIENTS RECEIVING HEALTH CARE SERVICES AT THE HEALTH CENTER. FIVE PHARMACISTS ARE ON STAFF TO OFFER MEDICATION COUNSELING FOR PRESCRIPTIONS. IN ADDITION, THE HEALTH CENTER EMPLOYED ONE FULL-TIME CLINICAL PHARMACIST TO ASSIST PATIENTS WITH CHRONIC MEDICAL CONDITIONS. SCHC IS A PARTICIPANT IN THE 340B DRUG PRICING PROGRAM AND ALSO OFFERS AN INDIGENT PROGRAM TO PROVIDE PRESCRIPTION ASSISTANCE TO QUALIFYING PATIENTS. THE SCHC PHARMACY ALSO PARTICIPATES IN OTHER PHARMACEUTICAL ASSISTANCE PROGRAMS TO ENSURE PATIENTS HAVE ACCESS TO NEEDED PRESCRIPTION DRUGS. 3678391 0 4337341 DENTAL CARE FOR FYE 2024: SCHC EMPLOYED SEVEN DENTISTS AND FIVE DENTAL HYGIENISTS TO PROVIDE ROUTINE DENTAL CARE AND TREATMENT TO PATIENTS AGED INFANTS TO ADULTS. EMERGENCY WALK-IN PATIENTS ARE ACCEPTED DAILY. THE DENTAL DEPARTMENT HAD 16,916 PATIENT VISITS DURING THE YEAR ENDING 1/31/24. 34668081 true true false true false false false false false true false false false true false true false false false false false false false false false false false true true true false false false false false false false false false false true false false false false false false false false true 80 0 true 405 true false false false false false false false false false false false false X 16 16 false false false false false false false true true false false true true true true true true true false false X JAN ANDERSON 7122522477 1021 NEBRASKA STREET SIOUX CITY IA 51105 ANDREA BUCKLEY BOARD CHAIR 1.0 0.0 X X 0 0 0 DAVID OLSON BOARD TREASURER 1.0 0.0 X X 0 0 0 DR DONA PRINCE BOARD VICE CHAIR 1.0 0.0 X X 0 0 0 TREYLA LEE SECRETARY 1.0 0.0 X X 0 0 0 ABDULLAHI URUR MEMBER AT LARGE 1.0 0.0 X 0 0 0 DIANE PRIEKSAT MEMBER AT LARGE END 7/23 1.0 0.0 X 0 0 0 DORA JUNG MEMBER AT LARGE 1.0 0.0 X 0 0 0 DR KEITH VOLLSTEDT MEMBER AT LARGE BEG 8/23 1.0 0.0 X 0 0 0 JANE ARNOLD MEMBER AT LARGE BEG 4/23 1.0 0.0 X 0 0 0 JAY ROSENBERG MEMBER AT LARGE 1.0 0.0 X 0 0 0 JENNIFER BRAVANTE-BURKHART MEMBER AT LARGE 1.0 0.0 X 0 0 0 JENNIFER JACKSON MEMBER AT LARGE 1.0 0.0 X 0 0 0 KELLEY MCCARTHY MEMBER AT LARGE END 2/23 1.0 0.0 X 0 0 0 LAWRENCE JENSEN MEMBER AT LARGE BEG 9/23 1.0 0.0 X 0 0 0 MONA ZUFFANTE MEMBER AT LARGE 1.0 0.0 X 0 0 0 NEIL BARTHOLOMEW MEMBER AT LARGE BEG 9/23 1.0 0.0 X 0 0 0 REVATHI TRUONG MEMBER AT LARGE 1.0 0.0 X 0 0 0 WILLIE SUAREZ MEMBER AT LARGE 1.0 0.0 X 0 0 0 JAN ANDERSON CHIEF FINANCIAL OFFICER 40.0 0.0 X 226836 0 67387 MARI KAPTAIN-DAHLEN CHIEF EXECUTIVE OFFICER 40.0 0.0 X 251712 0 55685 MICHAEL PIPLANI CHIEF MEDICAL OFFICER 40.0 0.0 X 357173 0 41639 ASHLEY HUBER DENTAL DIRECTOR 40.0 0.0 X 265884 0 58572 DAVID FALDMO QUALITY DIRECTOR 40.0 0.0 X 300578 0 80222 DYLAN GREENE PHYSICIAN 40.0 0.0 X 290447 0 67026 KELLY RYDER PHYSICIAN 40.0 0.0 X 284681 0 30727 KRISTI WALZ PHYSICIAN 40.0 0.0 X 330372 0 63543 THOMAS MORGAN PHYSICIAN 40.0 0.0 X 294457 0 62858 TYLER WENDEL PHYSICIAN 40.0 0.0 X 311339 0 62797 2913479 0 590456 51 false true false INCONCERTCARE INC 500 SW 7TH STREET STE 300 DES MOINES IA 50309 SOFTWARE SUPPORT 1067133 SIOUXLAND OBGYN 2730 PIERCE STREET SIOUX CITY IA 51104 OBSTETRICAL SERVICES 1010550 H & R CONSTRUCTION 307 E 39TH ST SOUTH SIOUX CITY NE 687763550 CONSTRUCTION 722438 FORVIS LLP 910 E ST LOUIS ST STE 200 SPRINGFIELD MO 65810 AUDIT/TAX/CONSULTING 216786 PRECISION IMAGING CONSULTANTS 1457 N 143RD AVE CIRCLE OMAHA NE 68154 RADIOLOGY READS 135610 6 6797935 5593812 1171862 12391747 NET PATIENT SERVICE REVENUE 624100 40927299 40927299 OTHER REVENUE 624100 81528 81528 0 0 0 0 41008827 1061959 1061959 0 0 0 109837 0 -109837 -109837 -109837 GAIN ON EQUITY INVESTEE 900099 66360 66360 0 0 0 0 66360 54419056 41008827 0 1018482 258118 258118 1705688 1104068 601620 21907438 17742656 4164782 782135 680295 101840 2229900 1871986 357914 1580867 1285756 295111 21523 21523 192056 192056 3235589 2090071 1145518 0 255101 174697 80404 606631 260087 346544 1552298 104852 1447446 337861 315180 22681 63902 58969 4933 445488 162786 282702 116854 116854 1875296 220170 1655126 221349 37828 183521 MEDICAL SUPPLIES & DRUGS 7980805 7980805 REPAIRS & MAINTENANCE 263810 257274 6536 LICENSES, DUES, SUBSCRIPTIONS 168329 62087 106242 RECRUITING & RETENTION 51842 396 51446 0 0 0 0 45852880 34668081 11184799 0 352701 330241 20716374 26055726 597931 250460 4025170 7744037 0 0 0 0 307205 506169 2459604 430416 30521693 11780412 18086843 18741281 688455 754815 0 1651796 1070221 532228 48304504 56997169 2833579 3303033 2407182 1947225 0 0 474714 566527 5715475 5816785 X 42506676 51027422 82353 152962 42589029 51180384 48304504 56997169 8566176 25179 0 X false true X true true true X 6344635 6713145 13312942 12399042 12391747 51161511 0 0 6344635 6713145 13312942 12399042 12391747 51161511 0 51161511 353248 134708 81390 450344 1061959 2081649 0 0 0 0 0 0 0 53243160 162235500 0.9609 0.9728 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE ORGANIZATION PAID DUES OF $20,000 TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND $64,853 TO THE IOWA PRIMARY CARE ASSOCIATION. A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES. 1715667 1715667 21516414 8284414 13232000 6879199 3495998 3383201 410413 410413 18741281 INTEREST RATE SWAP 32937 DEFERRED COMP LIABILITY 361513 ROU FINANCE LEASE LIABILITY 33046 ROU OPERATING LEASE LIABILITY 78215 ESTIMATED DUE TO THIRD PARTIES 60816 566527 54488613 25179 5150 82353 112682 54375931 43125 43125 54419056 45967867 5150 109837 114987 45852880 0 0 45852880 Schedule D, Part X, Line 2 UNCERTAIN TAX POSITIONS: 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. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 NET ASSETS RELEASED FROM RESTRICTIONS - 82353 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements LOSS ON DISPOSAL OF ASSETS - -109837 TEMPORARILY RESTRICTED CONTRIBUTIONS - 152962 Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 LOSS ON DISPOSAL OF ASSETS - 109837 true RENT ASSISTANCE 57 166111 0 0 0 UTILITIES ASSISTANCE 42 22405 0 0 0 CO-PAY ASSISTANCE 43 48975 0 0 0 PATIENT FOOD ASSISTANCE 101 20627 0 0 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. PATIENTS WITHIN THE HIV PROGRAM MAY QUALIFY FOR THE FOLLOWING PROGRAMS: RENTAL ASSISTANCE, MEDICAL/DENTAL/VISION CO-PAY ASSISTANCE, FOOD ASSISTANCE, AND UTILITIES ASSISTANCE. INDIVIDUALS MUST DEMONSTRATE A NEED FOR FINANCIAL ASSISTANCE AND THEY MUST FOLLOW-UP REGULARLY WITH THE STAFF AT THE CLINIC. X X X X false false false false false false false true false MICHAEL PIPLANI CHIEF MEDICAL OFFICER 348143 0 7625 0 1405 0 16500 0 25139 0 398812 0 0 0 MARI KAPTAIN-DAHLEN CHIEF EXECUTIVE OFFICER 239187 0 3100 0 9425 0 20519 0 35166 0 307397 0 0 0 JAN ANDERSON CHIEF FINANCIAL OFFICER 211038 0 3100 0 12698 0 30000 0 37387 0 294223 0 0 0 DAVID FALDMO QUALITY DIRECTOR 266406 0 22540 0 11632 0 28157 0 52065 0 380800 0 0 0 ASHLEY HUBER DENTAL DIRECTOR 246964 0 8500 0 10420 0 13727 0 44845 0 324456 0 0 0 KRISTI WALZ PHYSICIAN 315420 0 14310 0 642 0 12362 0 51181 0 393915 0 0 0 TYLER WENDEL PHYSICIAN 287049 0 14235 0 10055 0 15985 0 46812 0 374136 0 0 0 THOMAS MORGAN PHYSICIAN 281527 0 2875 0 10055 0 12203 0 50655 0 357315 0 0 0 DYLAN GREENE PHYSICIAN 281444 0 4840 0 4163 0 15276 0 51750 0 357473 0 0 0 KELLY RYDER PHYSICIAN 279336 0 3940 0 1405 0 14262 0 16465 0 315408 0 0 0 Schedule J, Part I, Line 7 Non-fixed payments MONTHLY INCENTIVE PAYMENTS BASED ON PRODUCTION ARE PAID TO EMPLOYEES SUBJECT TO THE DISCRETION OF THE BOARD OF DIRECTORS. A WOODBURY COUNTY IOWA 426005221 2007-09-25 7000000 CONSTRUCT NEW FACILITY false false false A 5034120 0 7000000 0 0 0 100000 0 6900000 0 0 0 2009 false false true true A false false false false 0.0 0.0 0.0 true false true A false false false true true true WELLS FARGO 20.0 false false false false false A true Schedule K, Part IV, Line 2c COLUMN A Issuer name: WOODBURY COUNTY, IOWA The calculation for computing no rebate due was performed on 11/07/2022 X 4 1171862 Market value 0 false true false Schedule M, Part I Explanations of reporting method for number of contributions Drugs and medical supplies - THE NUMBERS ENTERED IN COLUMN B REPRESENT THE NUMBER OF DONROS WHO CONTRIBUTED THESE ITEMS DURING THE YEAR. Form 990, Part III, Line 4 PROGRAM SERVICES SIOUXLAND COMMUNITY HEALTH CENTER (SCHC) IS DEDICATED TO MEETING THE HEALTHCARE NEEDS OF THE SIOUXLAND AREA AND IS A LEVEL THREE PATIENT CENTERED MEDICAL HOME. SCHC OFFERS THE FOLLOWING SERVICES: PRIMARY AND SPECIALTY MEDICAL SERVICES, FAMILY PLANNING SERVICES PRENATAL SERVICES, LABORATORY, RADIOLOGY, HIV/AIDS AND HEPATITIS CARE, BEHAVIORAL HEALTH, PHARMACY, AND DENTAL SERVICES. SCHC PROVIDES FINANCIAL ASSISTANCE TO THE UNINSURED AND UNDERINSURED TO ELIMINATE ACCESS BARRIERS. Form 990, Part III, Line 4a PROGRAM SERVICE ACTIVITY #1 LABORATORY SIOUXLAND COMMUNITY HEALTH CENTER LABORATORY CURRENTLY CONDUCTS APPROXIMATELY 96% OF ITS LABORATORY TESTS ONSITE AND IS A MODERATE COMPLEX LABORATORY. FOR THOSE TESTS NOT PERFORMED ONSITE, THEY ARE SENT TO A REFERENCE LABORATORY WHERE THE MAJORITY OF TEST RESULTS ARE RETURNED WITHIN 24-72 HOURS. CONDUCTING THE MAJORITY OF TESTS ONSITE ENSURES RAPID TURNAROUND FOR DIAGNOSIS AND MONITORING OF CHRONIC MEDICAL CONDITIONS. THE LABORATORY WAS ACCREDITED BY CLIA FOR THE YEAR ENDING 1/31/24, THE LABORATORY PERFORMED 498,694 TESTS. RADIOLOGY SCHC ALSO CONDUCTS RADIOLOGY SERVICES. IT PERFORMED 5,075 EXAMS FOR THE YEAR ENDING 1/31/24. SCHC ALSO STARTED PROVIDING ULTRASOUND SERVICES ON 3/1/20 AND PERFORMED 3,085 EXAMS FOR THE YEAR ENDING 1/31/24. HIV/AIDS AND HEPATITIS THE HIV TEAM SERVES THE TRI-STATE SIOUXLAND AREA, AS WELL AS 20 NORTHWEST IOWA COUNTIES, 6 COUNTIES IN NEBRASKA, AND 3 COUNTIES IN SOUTH DAKOTA. APPROXIMATELY 48% OF PATIENTS RECEIVING HIV/AIDS CARE LIVE IN RURAL AREAS. IN ADDITION TO MEDICAL CARE, THE HIV TEAM COORDINATES DENTAL CARE, CASE MANAGEMENT, TRANSPORTATION, AND HOUSING ASSISTANCE. FOR THE FISCAL YEAR ENDING 1/31/24, THE HIV TEAM SERVED 236 PATIENTS. FINANCIAL SERVICES TO ENSURE PATIENTS HAVE ACCESS TO CARE AT AN AFFORDABLE RATE, SCHC OFFERS A SLIDING FEE DISCOUNT TO PATIENTS BASED ON INCOME ELIGIBILITY AND ACCEPTS MEDICAID (TITLE 19), MEDICARE (TITLE 18), HAWK-I (STATE CHIP) AND MOST PRIVATE INSURANCES. FOR FISCAL YEAR ENDING 1/31/24, 14% OF PATIENTS RECEIVING CARE WERE UNINSURED, 49% HAD COVERAGE BY MEDICAID/HAWK-I, 11% HAD MEDICARE COVERAGE, AND 26% HAD COVERAGE BY OTHER SOURCES. SCHC EMPLOYED FIVE CERTIFIED APPLICATION COUNSELORS TO ASSIST INDIVIDUALS WITH ENROLLMENT IN THE HEALTH INSURANCE EXCHANGE. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CEO AND CFO REVIEW THE RETURN BEFORE IT IS PRESENTED TO THE FINANCE COMMITTEE. THE FINANCE COMMITTEE APPROVES THE RETURN, AND THE FINANCE COMMITTEE CHAIR MAKES A RECOMMENDATION TO THE BOARD FOR APPROVAL OF THE FORM 990 FOR FILING WITH THE IRS. BOARD MEMBERS RECEIVE THE FORM 990 AS HARD COPIES (MAILED OR HAND-DELIVERED) OR ELECTRONIC FILES (SENT VIA E-MAIL). Form 990, Part VI, Line 12c Conflict of interest policy A CONFLICT OF INTEREST POLICY IS STATED IN THE EMPLOYEE HANDBOOK. PER THE BYLAWS, IF A QUESTION CONCERNING A CONFLICT OF INTEREST FOR ANY DIRECTOR IS RAISED, A WRITTEN SECRET BALLOT MAY BE USED BY THE REMAINING DIRECTORS TO DETERMINE IF SUCH CONFLICT OF INTEREST EXISTS. SHOULD A CONFLICT OF INTEREST, PECUNIARY OR OTHERWISE, BE DETERMINED FOR ANY DIRECTOR, SUCH DIRECTOR SHALL BE EXCLUDED FROM VOTING ON THAT SUBJECT MATTER. A SIMPLE, AFFIRMATIVE MAJORITY OF THOSE PRESENT SHALL RULE. IN ALL EVENTS, A DIRECTOR SHALL DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE CEO'S COMPENSATION WAS EVALUATED IN 2023 BY THE EXECUTIVE BOARD OF DIRECTORS USING A COMPREHENSIVE CEO PERFORMANCE EVALUATION TOOL. THE EXECUTIVE BOARD ASSESSED THE CEO'S INDIVIDUAL PERFORMANCE, THE ORGANIZATION'S PERFORMANCE, AND WHETHER THE CEO ACCOMPLISHED THE MUTUALLY-AGREED UPON OBJECTIVES FOR THE FISCAL YEAR BEING REVIEWED. THE HR DIRECTOR CONDUCTS AN IN-DEPTH SALARY ANALYSIS ON A BI-ANNUAL BASIS WITH A CURSORY ANALYSIS DURING THE ALTERNATE YEARS. THE DATA USED IS OBTAINED LOCALLY, REGIONALLY, AND NATIONALLY. THIS ANALYSIS IS COMPILED AND A RECOMMENDATION IS TAKEN TO THE EXECUTIVE BOARD. THE CEO'S ANNUAL PERFORMANCE EVALUATION IS CALCULATED BY THE EXECUTIVE BOARD TO DETERMINE THE CURRENT YEAR SALARY, AND THE SALARY ANALYSIS IS COMPARED TO ENSURE THAT THE SALARY IS APPROPRIATE FOR THE POSITION AND PERFORMANCE. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS WILL BE PROVIDED TO INQUIRING PARTIES UPON REQUEST.