2023-02-28T15:30:47-06:00 2022-09-30 470677245 HBE LLP 7140 STEPHANIE LANE PO BOX 23110 LINCOLN NE 685423110 990 2021-10-01 470833378 MIDTOWN HEALTH CENTER MIDT 4023718000 302 W PHILLIP AVE NORFOLK NE 68701 KATHLEEN NORDBY CHIEF EXECUTIVE OFFICER 4023718000 2023-02-23 1 KATHLEEN NORDBY 999009999 ROSE M PINKMAN CPA CFE P02134111 4024234343 2023-02-23 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z KATHLEEN NORDBY 302 W PHILLIP AVE NORFOLK NE 68701 11112321 0 X WWW.MIDTOWNHEALTHNE.ORG X 1999 NE PROVIDE HIGH QUALITY MEDICAL, BEHAVIORAL HEALTH, AND DENTAL SERVICES THAT ARE AFFORDABLE, ACCESSIBLE, AND PATIENT-FOCUSED. 12 12 140 12 0 0 6581836 4788796 4769561 6263420 18759 23754 14286 36351 11384442 11112321 0 0 0 0 5771883 6334589 0 0 68190 2516832 3134635 8288715 9469224 3095727 1643097 9798512 11599492 1813007 1970890 7985505 9628602 PROVIDE HIGH QUALITY MEDICAL, BEHAVIORAL HEALTH, AND DENTAL SERVICES THAT ARE AFFORDABLE, ACCESSIBLE, AND PATIENT-FOCUSED. 0 0 7015895 6281871 MIDTOWN HEALTH CENTER IS A NON-PROFIT 501(C)(3) FEDERALLY QUALIFIED HEALTH CENTER (FQHC). MIDTOWN OFFERS MEDICAL, DENTAL, AND BEHAVIORAL HEALTH TO INSURED, UNINSURED, AND UNDER-INSURED INDIVIDUALS. THE NUMBER OF INDIVIDUALS MIDTOWN SERVES CONTINUES TO GROW. IN 2021, WE SAW 7,835 INDIVIDUALS REPRESENTING A 11.5% INCREASE FROM 2020 FOR A TOTAL OF 27,012 ENCOUNTERS. 26% PERCENT OF OUR PATIENTS DID NOT HAVE INSURANCE, 38.8% WERE ENROLLED IN EITHER MEDICAID OR MEDICARE AS THEIR THIRD PARTY PAYOR, 35.2% OF THE PATIENTS HAD INCOME BELOW THE 100% POVERTY GUIDELINE WITH A FULL 66.9% OF OUR PATIENTS DECLARING THEMSELVES AND THEIR HOUSEHOLD TO BE AT OR BELOW 200% OF POVERTY. 7015895 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 9 0 1 140 1 0 0 0 0 0 1 1 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X KATHY NORDBY 4023718000 302 W PHILLIP AVE NORFOLK NE 68701 BETTY FROEHLICH PAST CHAIR 2.00 X 0 0 0 ALAN EHLERS CHAIR 2.00 X X 0 0 0 JARECSY MEDINA BOARD MEMBER 2.00 X 0 0 0 LANCE MORROW TREASURER 2.00 X X 0 0 0 GRETCHEN FORSELL BOARD MEMBER 2.00 X 0 0 0 BRENDA JONES BOARD MEMBER 2.00 X 0 0 0 MARY LUHR BOARD MEMBER 2.00 X 0 0 0 SUSAN LUTZ VICE CHAIR 2.00 X X 0 0 0 JOE MTIKA BOARD MEMBER 2.00 X 0 0 0 SANDRA RENNER BOARD MEMBER 2.00 X 0 0 0 KAREN WEIDNER SECRETARY 2.00 X X 0 0 0 EUNICE RAMIREZ BOARD MEMBER 2.00 X 0 0 0 KATRIN LIMONTA BOARD MEMBER 2.00 X 0 0 0 KATHLEEN NORDBY CHIEF EXECUTIVE OFFICER 40.00 X 154999 0 20329 LINDA ANDERSON CHIEF FINANCIAL OFFICER 40.00 X 92762 0 5587 TERRI FORD-WOLFGRAM CHIEF OPERATING OFFICER 40.00 X 127087 0 11932 DR EMILY VUCHETICH PEDIATRICIAN 40.00 X 290110 0 51322 DR RAYMOND HELLER PHYSICIAN 32.00 X 209316 0 14912 DR DAVID SEGER DENTIST 40.00 X 163259 0 12802 DR LOISKA SIVAGANESHAN PHYSICIAN 36.00 X 192885 0 17820 1230418 0 134704 6 0 1 0 0 4407572 381224 49967 4788796 PATIENT REVENUE 621110 6187210 6187210 CONTRACT REVENUE 621110 76210 76210 6263420 23754 23754 17900 0 17900 17900 17900 18451 18451 18451 11112321 6281871 0 41654 542894 542894 4828944 3604369 1171570 53005 215418 172107 40780 2531 370622 252023 114893 3706 376711 279022 93586 4103 9101 9101 34628 34628 834461 712460 122001 82939 78792 4147 302386 227362 74326 698 152903 110090 42813 8483 2206 6277 37805 37805 43695 41478 2217 268823 228500 40323 33873 16937 16936 DENTAL, MEDICAL & PHARM 964265 964265 TECHNICAL ASSISTANCE 129315 55605 73710 ASSOCIATION DUES 123577 111219 12358 REPAIRS AND MAINTENANCE 55742 55185 557 52639 31842 20797 9469224 7015895 2385139 68190 136980 106444 3873679 6074774 763824 398960 591692 416119 181227 173382 5767377 1340716 3494740 4426661 6370 3152 750000 0 9798512 11599492 711548 888453 141357 194922 960102 887515 1813007 1970890 X 7985505 9628602 7985505 9628602 9798512 11599492 1643097 0 X X 0 1 X 1 1 1 X 4679085 3647059 4282830 6581837 4788796 23979607 4679085 3647059 4282830 6581837 4788796 23979607 23979607 28120 16640 19189 18759 23754 106462 5039 5039 24091108 18019609 0.99540 0.99480 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 769102 769102 3824008 621742 3202266 1174267 718974 455293 4426661 X 11112321 0 11112321 0 11112321 9469224 0 9469224 0 9469224 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT ON NET INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES. FOR THE YEAR ENDED SEPTEMBER 30, 2022, THE ORGANIZATION HAD NO TAX LIABILITY ON UNRELATED BUSINESS ACTIVITY. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: REIMBURSEMENTS PART XII, LINE 4B - OTHER ADJUSTMENTS: REIMBURSEMENTS 1 X 0 0 0 0 0 0 0 0 0 DR EMILY VUCHETICH PEDIATRICIAN 192701 0 97409 0 0 0 22275 0 29047 0 341432 0 0 0 DR RAYMOND HELLER PHYSICIAN 209316 0 0 0 0 0 13338 0 1574 0 224228 0 0 0 DR LOISKA SIVAGANESHAN PHYSICIAN 188600 0 4285 0 0 0 10890 0 6930 0 210705 0 0 0 DR DAVID SEGER DENTIST 158336 0 4923 0 0 0 6817 0 5985 0 176061 0 0 0 KATHLEEN NORDBY CHIEF EXECUTIVE OFFICER 150238 0 4761 0 0 0 8190 0 12139 0 175328 0 0 0 PART I, LINE 3 THERE IS A STUDY TO COMPARE PAY FROM LIKE ORGANIZATIONS ACROSS THE NATION AND MIDWEST. WE ALSO INCLUDE CONSIDERATION OF THE LOCAL MARKET FOR OTHER HEALTH CARE OR HEALTH DELIVERY AGENCIES LOCALLY THAT WE COMPETE WITH FOR STAFF. X 49967 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD FOR REVIEW BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C A NEW CONFLICT OF INTEREST POLICY IS DISTRIBUTED AND SIGNED ANNUALLY BY BOARD MEMBERS. THE POLICY CLEARLY STATES THE BOARD MEMBERS RESPONSIBILITY TO DISCLOSE EXISTING KNOWN CONFLICTS AT THAT TIME AND DISCLOSE FUTURE CONFLICTS OR POTENTIAL/PERCEIVED CONFLICTS AT THE TIME ANY NEW SITUATION OR DECISION MAY WARRANT SUCH DISCLOSURE. FORM 990, PART VI, SECTION B, LINE 15 THERE IS A STUDY TO COMPARE PAY FROM LIKE ORGANIZATIONS ACROSS THE NATION AND MIDWEST. WE ALSO INCLUDE CONSIDERATION OF THE LOCAL MARKET FOR OTHER HEALTH CARE OR HEALTH DELIVERY AGENCIES LOCALLY THAT WE COMPETE WITH FOR STAFF. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.