2024-10-29T07:38:08-05:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2023-01-01 134249732 GOOD NEIGHBOR COMMUNITY HEALTH CENTER GOOD 4025628961 4321 41ST AVENUE COLUMBUS NE 68601 TERRI FORD-WOLFGRAM CEO 4025628961 2024-10-28 1 1 KURT BENNION CPA P01469618 4252506100 2024-10-28 2023 2024-10-15 13:58:12Z TERRI FORD-WOLFGRAM 4321 41ST AVENUE COLUMBUS NE 68601 13586583 0 X WWW.GOODNEIGHBORCOMMUNITYHEALTHCENTER.COM X 2004 NE WORKING TOGETHER WITH THE COMMUNITY TO PROVIDE ACCESS TO QUALITY HEALTHCARE. 11 11 0 15 0 0 5653098 5900486 5255222 7558644 -29008 39580 22188 87873 10901500 13586583 16520 17909 0 0 6309884 7614759 0 0 0 4072231 4475937 10398635 12108605 502865 1477978 3706932 5341609 706629 863328 3000303 4478281 WORKING TOGETHER WITH THE COMMUNITY TO PROVIDE ACCESS TO QUALITY HEALTHCARE. 0 0 9040548 17909 7558644 COLLABORATION WITH FEDERAL, STATE AND COMMUNITY PARTNERS TO PROVIDE AFFORDABLE, COMPREHENSIVE, ACCESSIBLE, CULTURALLY RESPECTFUL, APPROPRIATE, COST-EFFECTIVE, QUALITY PRIMARY MEDICAL HEALTH CARE, DENTAL SERVICES AND BEHAVIORAL HEALTH SERVICES WITH SPECIAL ATTENTION TO THE UNDERSERVED. 9040548 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 0 1 1 1 0 1 1 1 1 1 1 1 1 1 0 0 X TERRI FORD-WOLFGRAM 4025628961 4321 41ST AVENUE COLUMBUS NE 68601 WENDY RAMAEKERS CHAIR 1.00 1.00 X X 0 0 0 ED WEMHOFF VICE CHAIR 1.00 1.00 X X 0 0 0 CONNIE PETERS SECRETARY 1.00 1.00 X X 0 0 0 MICHELLE STEPHAN TREASURER (THROUGH MARCH 2023) 1.00 0.00 X X 0 0 0 TORIBIO CHAVARRIA DIRECTOR 1.00 0.00 X 0 0 0 MARIA GONZALEZ DIRECTOR 1.00 0.00 X 0 0 0 RALPH HORACEK DIRECTOR 1.00 1.00 X 0 0 0 STACY LEU DIRECTOR (THROUGH JANUARY 2023) 1.00 0.00 X 0 0 0 DAWN MILLER DIRECTOR (THROUGH MARCH 2023) 1.00 0.00 X 0 0 0 GREG NABITY DIRECTOR 1.00 0.00 X 0 0 0 DR MATTHEW PIEPER DIRECTOR 1.00 1.00 X 0 0 0 LIZ RODRIGUEZ DIRECTOR 1.00 0.00 X 0 0 0 MARY STAUB DIRECTOR 1.00 1.00 X 0 0 0 NATHAN WILLIAMS DIRECTOR 1.00 0.00 X 0 0 0 TERRI FORD-WOLFGRAM CEO 32.00 8.00 X 0 175400 4681 0 175400 4681 0 0 1 0 COMMUNITY LINK CONSULTING PO BOX 276 NEWMAN LAKE WA 99025 MEDICAL BILLING AND ICFO CONSULTING 543728 GREENWAY HEALTH PO BOX 203658 DALLAS TX 753203658 SOFTWARE SUPPORT & STAFF TRAINING 213063 BARTON & ASSOCIATES PO BOX 417844 BOSTON MA 02241 LOCUM DENTIST SERVICES 207627 HEARTLAND COMMUNITY HEALTH NETWORK 4920 S 30TH STREET 103 OMAHA NE 68107 E.H.R. SUPPORT & TRAINING 187200 NEXTGEN PO BOX 89390 CHICAGO IL 60680 E.H.R. SUPPORT & TRAINING 125406 5 5728765 171721 5900486 NET PATIENT SERVICE REVENUE 621400 6382196 6382196 PHARMACY INCOME 456110 1176448 1176448 7558644 39020 39020 7784 0 7784 7784 7784 560 0 560 560 560 MISCELLANEOUS INCOME 900099 80089 80089 80089 13586583 7558644 0 127453 17909 17909 5552719 3917412 1635307 76934 56561 20373 1602256 1013618 588638 382850 269639 113211 3240 3240 39072 39072 620603 616041 4562 13015 11427 1588 107019 50842 56177 619102 479885 139217 740333 680254 60079 42123 26269 15854 24027 12643 11384 10142 7140 3002 259569 18598 240971 22960 22960 MEDICAL SUPPLIES 1132538 1126043 6495 BAD DEBT 690328 690328 REPAIRS & MAINTENANCE 111598 21976 89622 OTHER EXPENSES 40268 23963 16305 12108605 9040548 3068057 0 1004185 2385985 283473 110125 153652 583272 12758 24700 3686174 1448647 2252864 2237527 3706932 5341609 535467 627004 122824 171162 113500 706629 863328 X 3000303 4478281 3000303 4478281 3706932 5341609 1477978 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1433522 159991 1273531 1253106 849965 403141 999546 438691 560855 2237527 DUE TO RELATED ORGANIZATION 113500 113500 13578239 0 13578239 8344 8344 13586583 11544666 0 11544666 563939 563939 12108605 PART XI, LINE 4B - OTHER ADJUSTMENTS: GAIN ON SALE OF FIXED ASSETS 560. RENTAL INCOME 7,784. PART XII, LINE 4B - OTHER ADJUSTMENTS: NET RENTAL EXPENSES 523,886. CAPITAL OUTLAYS 31,709. GAIN ON SALE OF FIXED ASSETS 560. RENTAL INCOME 7,784. 1 TRANSPORTATION ASSISTANCE 1525 0 17909 COST VEHICLE AND LABOR COSTS PART I, LINE 2: THE ORGANIZATION PROVIDES TRANSPORTATION ASSISTANCE TO CUSTOMERS IN NEED. NO FUNDS ARE GIVEN TO INDIVIDUALS. 0 0 0 0 0 0 0 0 0 TERRI FORD-WOLFGRAM CEO 0 160000 0 15400 0 0 0 3538 0 1143 0 180081 0 0 PART I, LINE 3 THE CEO'S COMPENSATION IS DETERMINED BY EAST-CENTRAL DISTRICT HEALTH DEPARTMENT, INCLUDING USE OF THE FOLLOWING: 1. COMPENSATION COMMITTEE 2. COMPENSATION SURVEY OR STUDY 3. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF GOOD NEIGHBOR COMMUNITY HEALTH CENTER IS EAST-CENTRAL DISTRICT HEALTH DEPARTMENT, A POLITICAL SUBDIVISION OF THE STATE OF NEBRASKA. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS THE POWER TO (A) APPROVE THE ORGANIZATION'S COMMUNITY HEALTH CENTER RENEWAL APPLICATION, ANNUAL BUDGET, BUDGETS FOR OPERATIONS, CAPITAL EXPENDITURES, AND CASH FLOW; (B) REVIEW AND APPROVE THE ORGANIZATION'S SERVICES AND HOURS WHEN SERVICES ARE PROVIDED, LOCATIONS, AND MODE OF DELIVERY; (C) APPROVE THE ORGANIZATION'S MERGER, CONSOLIDATION OR DISSOLUTION; (D) APPROVE ANY CHANGE IN THE ORGANIZATION'S PURPOSE, PHILOSOPHY OR OBJECTIVES; (E) APPROVE THE PURCHASE, SALE, LEASE, TRANSFER OR ENCUMBERANCE OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S PROPERTY; (F) AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; AND (G) APPOINT AND REMOVE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO BEING FILED, THE FORM 990 WAS REVIEWED BY THE CFO AND CEO, WAS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE, AND WAS PROVIDED TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS AND EMPLOYEES. WHEN AN EMPLOYEE HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, THEY NOTIFY THE CEO, WHO DETERMINES WHETHER A CONFLICT EXISTS AND THE APPROPRIATE RESPONSE. WHEN THE CEO OR A BOARD MEMBER HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN REGARDS TO A TRANSACTION, THEY NOTIFY THE BOARD AND PROVIDE RELEVANT INFORMATION, AFTER WHICH THEY LEAVE THE MEETING FOR FURTHER DISCUSSIONS AND VOTES ON THE MATTER. IF IT ISN'T CLEAR WHETHER A CONFLICT EXISTS, THE REMAINING BOARD MEMBERS MAKE THE DETERMINATION. THE BOARD MAY EVALUATE WHETHER THE ORGANIZATION CAN ENTER AN AGREEMENT THAT IS EQUALLY ADVANTAGEOUS TO THE ORGANIZATION AND DOES NOT INVOLVE A CONFLICT OF INTEREST. IF THE BOARD BELIEVES A PERSON HAS FAILED TO IDENTIFY A CONFLICT OF INTEREST, THE INDIVIDUAL IS NOTIFIED AND GIVEN A CHANCE TO RESPOND, AFTER WHICH THE BOARD DETERMINES WHETHER ANY DISCIPLINARY OR CORRECTIVE ACTIONS ARE REQUIRED. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION IS EVALUATED BY THE H.R. DEPARTMENT OF EAST-CENTRAL DISTRICT HEALTH DEPARTMENT, BASED ON MULTIPLE SALARY SURVEYS, WITH A RECOMMENDATION BEING MADE TO EAST-CENTRAL DISTRICT HEALTH DEPARTMENT'S BOARD OF TRUSTEES AND GOOD NEIGHBOR COMMUNITY HEALTH CENTER'S BOARD OF DIRECTORS, WHO THEN REVIEW AND APPROVE THE COMPENSATION RECOMMENDATION. THIS PROCESS IS CONDUCTED ANNUALLY. THE CFO'S COMPENSATION IS EVALUATED BY THE H.R. DEPARTMENT OF EAST-CENTRAL DISTRICT HEALTH DEPARTMENT, BASED ON MULTIPLE SALARY SURVEYS, WITH A RECOMMENDATION BEING MADE TO THE CEO, WHO THEN REVIEWS AND APPROVES THE COMPENSATION RECOMMENDATION. THIS PROCESS IS CONDUCTED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE AUTHORITY AND PROCESS OF SELECTING AN INDEPENDENT ACCOUNTANT AND OVERSEEING THE FINANCIAL STATEMENT AUDIT DID NOT CHANGE DURING THE YEAR. EAST-CENTRAL DISTRICT HEALTH DEPARTMENT 4321 41ST AVENUE COLUMBUS NE 68601 470835183 INTER-COUNTY HEALTH DEPARTMENT NE N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0