2024-11-22T10:12:15-06:00 2024-02-29 363168081 SIKICH LLC 17335 GOLF PARKWAY SUITE 500 BROOKFIELD WI 53045 990 2023-03-01 391789874 KENOSHA COMMUNITY HEALTH CENTER INC KENO 2627713560 4006 WASHINGTON RD KENOSHA WI 53144 JOHN STAMPFL INTERIMCHIEF FINANCIAL OFFICER 2627643608 2024-11-21 1 0 JILL M BOYLE CPA P01246734 2627549400 2024-11-21 2023 2024-10-15 13:58:12Z MARY OUIMET 4006 WASHINGTON RD KENOSHA WI 53144 18026518 0 X WWW.KENOSHACHC.ORG X 1994 WI TO PROVIDE ACCESS TO HEALTH CARE SERVICES AND REDUCE HEALTH DISPARITIES FOR THE UNDERSERVED PEOPLE. 13 13 196 15 0 0 11142383 3628572 8718223 11613206 55024 102869 121442 173700 20037072 15518347 0 0 0 0 9632568 11438142 0 0 0 5048992 6360474 14681560 17798616 5355512 -2280269 17141994 14671666 3551815 3357218 13590179 11314448 X KENOSHA COMMUNITY HEALTH CENTER, INC.'S PURPOSE IS TO PROVIDE PRIMARY CARE AND REFERRAL HEALTH SERVICES TO DISADVANTAGED AND UNDERSERVED POPULATIONS AND PROMOTE AND ENSURE THAT BASIC PRIMARY HEALTH SERVICES ARE ACCESSIBLE TO UNINSURED AND UNDERINSURED RESIDENTS OF KENOSHA, WISCONSIN AND SURROUNDING COMMUNITIES. 0 0 6042556 5265755 DENTAL CAREINCREASE ACCESS TO COMPREHENSIVE DENTAL CARE SERVICES FOR MEDICAID ENROLLEES AND THE UNINSURED. 5122291 4257313 MEDICAL CAREINCREASE ACCESS TO COMPREHENSIVE MEDICAL CARE SERVICES FOR MEDICAID ENROLLEES AND THE UNINSURED. 1752029 2220631 BEHAVIORAL HEALTH SERVICESINCREASE ACCESS TO COMPREHENSIVE MEDICAL CARE FOR BEHAVIORAL HEALTH CARE SERVICES FOR MEDICAID ENROLLEES AND THE UNINSURED. 12916876 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 20 0 196 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X JOHN STAMPFL 2627713561 4006 WASHINGTON RD KENOSHA WI 53144 TAMARRA COLEMAN BOARD MEMBER & BOARD PRES 1.00 X X 0 0 0 ANITA JOHNSON BOARD MEMBER & BOARD VP 1.00 X X 0 0 0 DAVID GEERTSEN BOARD MEMBER & TREASURER 1.00 X X 0 0 0 DANA BERRY BOARD MEMBER & SECRETARY 1.00 X X 0 0 0 PAUL SPOTTSWOOD BOARD MEMBER 1.00 X 0 0 0 JOHN ROCHA II BOARD MEMBER 1.00 X 0 0 0 KATHERINE WOESTE BOARD MEMBER 1.00 X 0 0 0 VENKATA THOTA BOARD MEMBER 1.00 X 0 0 0 ERIN GINN BOARD MEMBER 1.00 X 0 0 0 MARIA LALL BOARD MEMBER 1.00 X 0 0 0 KATHERINE EASTHON BOARD MEMBER 1.00 X 0 0 0 TIMOTHY SANBORN BOARD MEMBER (THRU 06/06/23) 1.00 X 0 0 0 RONALD TATUM BOARD MEMBER 1.00 X 0 0 0 STEPHEN NEUBERGER BOARD MEMBER 1.00 X 0 0 0 MARY OUIMET CHIEF EXECUTIVE OFFICER 40.00 X 238847 0 6416 JOHN VASELANEY CHIEF DENTAL OFFICER (THRU 01/08/24) 40.00 X 202402 0 22371 GARY MOSS CHIEF FINANCIAL OFFICER (THRU 02/01/24) 40.00 X 170397 0 2660 JOHN STAMPFL INTERIM CHIEF FINANCIAL OFFICER 40.00 X 133377 0 1398 TIMOTHY SANBORN CHIEF CLINICAL OFFICER (START 6/6/23) 40.00 X 83654 0 0 DAVID CONNELL DENTIST 40.00 X 200965 0 23904 AMALOU LIM DENTIST 40.00 X 195260 0 0 MATHEW MCCARTHY PSYCHIATRIST 40.00 X 184434 0 16590 JOSE VILLANUEVA DENTIST 40.00 X 171195 0 5917 KENDALL WILKES DENTIST 40.00 X 165079 0 3212 1745610 0 82468 26 0 1 0 PANACEA SOLUTIONS LLC 4136 TECHNOLOGY PARKWAY SHEBOYGAN WI 53083 IT AND REVENUE CYCLE SERVICES 561866 OCHIN INC PO BOX 5426 PORTLAND OR 97728 ELECTRONIC HEALTH RECORDS 362913 CLEAN & GREEN SOLUTIONS 5008 GREEN BAY RD STE 3 KENOSHA WI 53144 JANITORIAL SERVICES 242614 RILEY CONSTRUCTION 5301 99TH AVE KENOSHA WI 53144 CONSTRUCTION SERVICES 226448 GREENWAY HEALTH PO BOX 203658 DALLAS TX 753203658 ELECTRONIC HEALTH RECORDS 195612 9 3618925 9647 3628572 PATIENT SERVICE FEE 621110 9220015 9220015 PHARMACY REVENUE 900099 2165238 2165238 RCHC PATIENT SERVICE 621110 227953 227953 11613206 77067 77067 130493 0 130493 130493 130493 2533973 2508171 25802 25802 25802 MISCELLANEOUS REVENUE 900099 43207 43207 43207 15518347 11743699 0 146076 896162 335031 561131 8881666 6031843 2849823 965668 600568 365100 694646 432926 261720 94009 20381 73628 1191344 1156871 34473 189833 148274 41559 92266 66892 25374 1503095 1251772 251323 234069 228943 5126 24649 16427 8222 12885 1453 11432 64909 32 64877 961047 775552 185495 91282 91282 MEDICAL & LAB EXPENSE 1420263 1416686 3577 EQUIPMENT 285264 277097 8167 STAFF DEVELOPMENT 87749 14874 72875 DUES & SUBSCRIPTIONS 56671 9483 47188 51139 40489 10650 17798616 12916876 4881740 0 600 450 1067310 1187353 66561 180779 820558 1006790 231570 197378 19595287 8104161 11922827 11491126 3032568 607790 17141994 14671666 1596726 1603329 94703 18695 1860386 1735194 3551815 3357218 X 13590179 11314448 13590179 11314448 17141994 14671666 -2280269 4538 0 X 0 1 X 1 1 1 X 3885806 6920754 7301308 11142383 3628572 32878823 3885806 6920754 7301308 11142383 3628572 32878823 32878823 423 77 1474 151036 77067 230077 46384 8457 29302 25430 43207 152780 33261680 40617082 0.98850 0.99130 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2019 AMOUNT: $ 46,384. 2020 AMOUNT: $ 8,457. 2021 AMOUNT: $ 29,302. 2022 AMOUNT: $ 25,430. 2023 AMOUNT: $ 43,207. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 888847 888847 11401316 3608854 7792462 842220 266703 575517 4484183 3517526 966657 1978721 711078 1267643 11491126 X 15522885 4538 4538 15518347 0 15518347 17798616 0 17798616 0 17798616 PART X, LINE 2: THE CENTER IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AS OTHER THAN A PRIVATE FOUNDATION AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE LLC IS CONSIDERED A DISREGARDED ENTITY FOR INCOME TAX PURPOSES. THE ORGANIZATION EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO RECORDED UNCERTAIN TAX POSITIONS RECORDED IN 2024, 2023, OR 2022. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION FILES VARIOUS FEDERAL OR STATE NON-PROFIT TAX RETURNS. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL OR STATE EXAMINATIONS BY TAX AUTHORITIES FOR YEARS PRIOR TO 2020. X X X 0 0 0 0 0 0 0 1 0 MARY OUIMET CHIEF EXECUTIVE OFFICER 226847 0 12000 0 0 0 0 0 6416 0 245263 0 0 0 DAVID CONNELL DENTIST 183737 0 17228 0 0 0 0 0 23904 0 224869 0 0 0 JOHN VASELANEY CHIEF DENTAL OFFICER (THRU 01/08/24) 191629 0 10773 0 0 0 0 0 22371 0 224773 0 0 0 MATHEW MCCARTHY PSYCHIATRIST 184434 0 0 0 0 0 0 0 16590 0 201024 0 0 0 AMALOU LIM DENTIST 186000 0 9260 0 0 0 0 0 0 0 195260 0 0 0 JOSE VILLANUEVA DENTIST 164083 0 7112 0 0 0 0 0 5917 0 177112 0 0 0 GARY MOSS CHIEF FINANCIAL OFFICER (THRU 02/01/ 161644 0 8753 0 0 0 0 0 2660 0 173057 0 0 0 KENDALL WILKES DENTIST 162173 0 2906 0 0 0 0 0 3212 0 168291 0 0 0 PART I, LINE 7 IN FY 2024, KCHC PAID SEVERANCE OF $22,307.70 TO DR. JOHN VASELANEY, CHIEF DENTAL OFFICER AND $12,006.86 TO GARY MOSS, CHIEF FINANCIAL OFFICER. IN ADDITION, IN FY 2024, KCHC ACCRUED SEVERANCE OF $31,538.47 TO DR. VASELANEY AND $32,228.94 TO MR. MOSS. THIS ACCRUED SEVERANCE WAS PAID IN MARCH, APRIL AND MAY 2024. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CHAIRPERSON OF THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL NEW BOARD MEMBERS TO SIGN A CONFLICT OF INTEREST STATEMENT. BOARD MEMBERS ARE REQUIRED TO UPDATE THESE STATEMENTS ANNUALLY. SHOULD A CONFLICT ARISE, THE PERSON AFFECTED IS ASKED TO EXCUSE THEMSELVES FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 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 NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, AND GENERALIST HUMAN RESOURCES ORGANIZATIONS AND RECEIVE THOSE REPORTS. THERE ARE ALSO PERIODIC SPOT CHECKS LOCALLY FOR SPECIFIC POSITIONS. COMPENSATION FOR TOP MANAGEMENT IS APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. KCHC REAL ESTATE LLC 4536 22ND AVENUE KENOSHA WI 53140 391789874 REAL ESTATE HOLDINGS WI 480000 8497651 KENOSHA COMMUNITY HEALTH CENTER INC