2025-01-13T14:47:29-06:00 2024-03-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-04-01 391181480 LA CLINICA DE LOS CAMPESINOS INC LACL 9207875514 400 S TOWNLINE ROAD WAUTOMA WI 54982 LAURA WALDVOGEL PRESIDENT & CEO 9207875514 2025-01-13 1 1 JESSICA NATUS P01799381 2187224705 2025-01-13 2023 2024-10-15 13:58:12Z FAMILY HEALTH LA CLINICA LAURA WALDVOGEL 400 S TOWNLINE ROAD WAUTOMA WI 54982 22332563 0 X HTTPS://NOBLECLINICS.ORG/ X 1973 WI TO ENSURE ACCESS TO HIGH QUALITY INTEGRATED HEALTHCARE AND PROMOTE THE WELL-BEING OF OUR PATIENTS, STAFF, AND COMMUNITIES. 13 13 231 14 0 0 7019299 6325602 24176432 15642311 93997 -549431 0 0 31289728 21418482 10000 10000 0 0 15542304 16061562 0 0 0 5984725 8263065 21537029 24334627 9752699 -2916145 21538371 21244485 3353259 5944352 18185112 15300133 TO ENSURE ACCESS TO HIGH QUALITY INTEGRATED HEALTHCARE AND PROMOTE THE WELL-BEING OF OUR PATIENTS, STAFF, AND COMMUNITIES. 0 0 18010141 10000 15642311 COMMUNITY AND MIGRANT HEALTH CLINIC CENTER THAT PROVIDES PRIMARY MEDICAL, BEHAVIORAL HEALTH, AND DENTAL HEALTH SERVICES TO COMMUNITY RESIDENTS AND MIGRANT PATIENTS. THE WISCONSIN COMMUNITY HEALTH CENTER GRANT ENABLES LA CLINICA TO PROVIDE COMMUNITY AND MIGRANT PATIENTS ACCESS TO MEDICAL AND DENTAL SERVICES. IN ADDITION, BEHAVIORAL HEALTH SERVICES ARE PROVIDED WHICH INCLUDE MEDICATION ASSISTED TREATMENT FOR SUBSTANCE AND ALCOHOL ABUSE. 297401 0 0 THE WOMEN, INFANT, AND CHILDREN'S GRANT ALLOWS LA CLINICA TO PROVIDE SUPPLEMENTAL NUTRITION AND EDUCATION TO CLIENTS IN THE PROGRAM SERVICES AREA. 18307542 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 39 0 231 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 1 1 1 1 1 1 1 1 0 X BRIAN AHLGREN 9207875514 400 S TOWNLINE ROAD WAUTOMA WI 54982 ALMA DELIA TORRES VICE CHAIR 1.00 X X 0 0 0 AARON WILLIAMS CHAIR 1.00 X X 0 0 0 SHEILA SHAW TREASURER 1.00 X X 0 0 0 HEIDI DELGADILLO SECRETARY 1.00 X X 0 0 0 LORA BLASIUS DIRECTOR 1.00 X 0 0 0 PETER GIERACH DIRECTOR 1.00 X 0 0 0 BRENDA HENKE DIRECTOR 1.00 X 0 0 0 ROSEANNE HENNING DIRECTOR 1.00 X 0 0 0 FRED JOHANNES DIRECTOR 1.00 X 0 0 0 PAUL MOTT DIRECTOR 1.00 X 0 0 0 JUANITA 'TERRY' OLIVAS DIRECTOR 1.00 X 0 0 0 LINDA SHELLEY DIRECTOR 1.00 X 0 0 0 PAUL THEYEL DIRECTOR 1.00 X 0 0 0 DAMARIS THOME DIRECTOR 1.00 X 0 0 0 LAURA WALDVOGEL PRESIDENT & CEO 40.00 X 249663 0 63913 THOMAS KAMINSKI CFO 40.00 X 198951 0 53535 KEVIN THAO PHYSICIAN 28.00 X 215234 0 50388 JAVIER RINCON PHYSICIAN 28.00 X 205974 0 25046 SAVITA BIMARTHI CDO/DENTIST 40.00 X 172248 0 47343 NATHAN DAILY DENTIST 32.00 X 182740 0 46149 SAMANTHA SEILER PHYSICIAN 40.00 X 231556 0 50523 1456366 0 336897 27 0 1 0 BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 022417844 LOCUM DENTIST SERVICES 737433 UTSCHIG INC N1040 CRAFTSMEN DRIVE GREENVILLE WI 54942 CONSTRUCTION SERVICES 692070 SOMERVILLE INC 2100 RIVERSIDE DR GREEN BAY WI 54301 CONSTRUCTION SERVICES 347590 OCHIN INC PO BOX 5426 PORTLAND OR 972285426 SOFTWARE AND CONSULTING 330455 WIPFLI CPAS AND CONSULTANTS PO BOX 3160 MILWAUKEE WI 532013160 ACCOUNTING 185544 8 6054247 271355 6325602 PATIENT SERVICE REVENUE 621110 15254096 15254096 340B PROGRAM REVENUE 900099 100431 100431 287784 287784 15642311 364650 364650 914081 -914081 -914081 -914081 21418482 15642311 0 -549431 10000 10000 590880 590880 11814059 9938004 1876055 426939 354378 72561 2324099 1901689 422410 905585 712243 193342 12034 12034 45939 45939 9080 9080 2279451 1586657 692794 212215 59998 152217 1025204 432551 592653 631924 497009 134915 748619 299644 448975 206664 150430 56234 35630 28023 7607 177340 14322 163018 730329 432617 297712 175007 37198 137809 MEDICAL SUPPLIES 954980 954980 BAD DEBT EXPENSE 698155 698155 REPAIRS & MAINTENANCE 136115 82904 53211 DUES, PUBLICATIONS & ME 91488 31498 59990 92891 85242 7649 24334627 18307542 6027085 0 10984785 3683761 277853 278508 237702 109209 1120692 1133399 93611 56693 169059 231455 16722982 6775116 8255735 9947866 5213309 492545 496674 21538371 21244485 1513308 1857468 395294 1577961 3450889 261990 240701 3353259 5944352 X 17813246 14922389 371866 377744 18185112 15300133 21538371 21244485 X -2916145 31166 X X 0 1 X 1 1 1 X PART I, LINE 3 LA CLINICA DE LOS CAMPESINOS IS A NOT-FOR-PROFIT CORPORATION THAT PROVIDES HEALTHCARE SERVICES THROUGH MEDICAL, BEHAVIORAL AND DENTAL CLINICS. IT IS NOT REQUIRED TO BE LICENSED AS A HOSPITAL AND THEREFORE IS NOT REQUIRED TO COMPLETE SCHEDULE H. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 725004 725004 9425121 2267868 7157253 463534 24620 438914 4026640 3420333 606307 2082683 1062295 1020388 9947866 INVESTMENTS - ASSOCIATED BANKS 4951503 F GOLDMAN SACHS 178174 F INTEREST RECEIVABLE 83632 F 5213309 RIGHT OF USE OBLIGATION - OPERATING LEASE 240701 240701 X 20663129 -777439 -777439 21440568 9080 -31166 -22086 21418482 23548108 0 23548108 9080 777439 786519 24334627 PART X, LINE 2: TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CLINIC DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT DOES NOT BELIEVE THE CLINIC HAS ANY MATERIAL UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. PART XI, LINE 2D - OTHER ADJUSTMENTS: 340B EXPENSES -79,284. BAD DEBT EXPENSE -698,155. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN COMMUNITY FUND -31,166. PART XII, LINE 4B - OTHER ADJUSTMENTS: 340B EXPENSES 79,284. BAD DEBT EXPENSE 698,155. 1 SCHOLARSHIP 1 10000 CASH PART I, LINE 2: THE SCHOLARSHIPS AWARDED ARE MANAGED BY AN OUTSIDE FOUNDATION. THE FOUNDATION MAINTAINS THE RECORDS AND ENSURES THE RECIPIENTS MEET THE ELIGIBILITY REQUIREMENTS. X X 0 0 0 0 0 0 0 0 0 LAURA WALDVOGEL PRESIDENT & CEO 249663 0 0 0 0 0 13319 0 50594 0 313576 0 0 0 SAMANTHA SEILER PHYSICIAN 223320 0 0 0 8236 0 9401 0 41122 0 282079 0 0 0 KEVIN THAO PHYSICIAN 195210 0 0 0 20024 0 7794 0 42594 0 265622 0 0 0 THOMAS KAMINSKI CFO 198951 0 0 0 0 0 10317 0 43218 0 252486 0 0 0 JAVIER RINCON PHYSICIAN 205974 0 0 0 0 0 0 0 25046 0 231020 0 0 0 NATHAN DAILY DENTIST 182740 0 0 0 0 0 9360 0 36789 0 228889 0 0 0 SAVITA BIMARTHI CDO/DENTIST 172248 0 0 0 0 0 8913 0 38430 0 219591 0 0 0 KEVIN THAO CMO HIGHEST COMPENATED EMPLOYEE INCENTIVE PACKAGE X 150000 70000 0 0 1 SAMANTHA SEILER HIGHEST COMPENATED EMPLOYEE INCENTIVE PACKAGE X 50000 23611 0 0 1 93611 FORM 990, PART VI, SECTION B, LINE 11B THE PREPARED FORM 990 IS REVIEWED BY THE CFO AND CEO AND APPROVED BY THE BOARD OF DIRECTORS BEFORE THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL DIRECTORS AND OFFICERS DISCLOSE ALL INFORMATION REGARDING THEIR INTERESTS AND THOSE OF THEIR FAMILY MEMBERS THAT COULD GIVE RISE TO CONFLICTS THE MEMBERS OF GOVERNING BODY MAKE DETERMINATIONS OF WHETHER A CONFLICT EXISTS AND REVIEW ACTUAL CONFLICTS. ANY PERSON WITH A CONFLICT IS PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS ANNUALLY DETERMINE THE CEO'S COMPENSATION USING DATA ON COMPENSATION PAID BY COMPARABLE ORGANIZATIONS IN SIMILAR COMMUNITIES FOR SIMILAR SERVICES. IN DETERMINING COMPENSATION FOR OFFICERS AND KEY EMPLOYEES, THE PROCESS INCLUDES REVIEW BY THE DIRECTOR OF HUMAN RESOURCES AND APPROVAL OF THE CEO IN ALIGNMENT WITH BOARD APPROVED SALARY SCHEDULES WHICH ARE CREATED USING COMPARABILITY DATA TO ENSURE ALIGNMENT WITH MARKET STANDARDS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN CASH SURRENDER VALUE OF DEFERRED ANNUITY 31,166. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.