2023-11-14T11:04:42-06:00 2022-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2022-01-01 237113799 SOUTHSIDE COMMUNITY HEALTH SERVICES INC SOUT 6128212025 4243 FOURTH AVENUE SOUTH MINNEAPOLIS MN 55409 ANN CAZABAN EXECUTIVE DIRECTOR 6128212025 2023-08-16 1 ANN CAZABAN 999009999 0 MICHAEL J PETERSON CPA P01833529 2187224705 2023-08-16 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ANN CAZABAN 4243 FOURTH AVENUE SOUTH MINNEAPOLIS MN 55409 11458189 0 X WWW.SOUTHSIDECHS.ORG X 1971 MN TO PROVIDE HIGH QUALITY HEALTH CARE IN THE COMMUNITIES SERVED. 10 10 133 15 0 0 5963359 6233956 5591309 5215954 1754 8279 14625 0 11571047 11458189 0 0 0 0 6986736 7198924 0 64055 64055 3492583 3772505 10479319 11035484 1091728 422705 4106552 4837894 1080357 1388994 3026195 3448900 X IMPROVING THE HEALTH OF OUR PATIENTS AND COMMUNITIES BY DELIVERING EXCEPTIONAL CARE, REMOVING BARRIERS, AND PROMOTING HEALTHY LIFESTYLES. 0 0 4823967 0 1388294 MEDICAL:SOUTHSIDE COMMUNITY HEALTH SERVICES, INCE (SCHS) IS A 501(C)(3) NONPROFIT ORGANIZATION AND IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) LOCATED IN SOUTH MINNEAPOLIS. SOUTHSIDE MEDICAL CURRENTLY PROVIDES FAMILY PRACTICE MEDICINE INCLUDING SPECIAL PROGRAMS FOR AT RISK POPULATIONS, FAMILY PLANNING, PRENATAL AND PEDIATRICS. WHILE THE MAJORITY OF PATIENTS COME FROM THE SOUTHSIDE OF MINNEAPOLIS, SCHS CONTINUES TO HAVE AN "ESSENTIAL COMMUNITY SAFETY NET PROVIDER" DESIGNATION FROM THE STATE OF MINNESOTA. IN 2022, SOUTHSIDE SERVICED 12,766 MEDICAL PATIENT VISITS (NOT INCLUDING COVID-19 VACCINE VISITS: 15,739). 3888816 0 3827660 DENTAL:SOUTHSIDE DENTAL CLINIC CURRENTLY PROVIDES GENERAL DENTAL SERVICES FOR PEOPLE OF ALL AGES. SOUTHSIDE CURRENTLY OPERATES FOURTEEN DENTAL OPERATORIES. IN 2022, THE DENTAL CLINIC PROVIDED 17,893 VISITS. 0 0 0 OUTREACH:SOUTHSIDE'S OUTREACH PROGRAM PROVIDES THE COMMUNITY WITH INNOVATIVE PROGRAMS, ACTIVITIES AND EDUCATIONAL OPPORTUNITIES DESIGNED TO IMPROVE HEALTH LITERACY AND ASSIST PEOPLE IN GETTING INVOLVED IN THEIR PERSONAL HEALTH CARE. IT HAS BEEN PROVIDED THAT THE EARLIER HEALTHY PRACTICES ARE ESTABLISHED, THE BETTER THE QUALITY OF LIFE FOR THE INDIVIDUAL. THESE PRACTICES CAN INCLUDE HEALTH DIET, CONSISTENT EXERCISE, AND MONITORING LIFESTYLE CHOICES. BEHAVIORAL HEALTH:SOUTHSIDE OPERATES A BEHAVIORAL HEALTH PRACTICE THAT IS INTEGRATED INTO PRIMARY CARE AND SERVICES INCLUDE THERAPY, FAMILY SUPPORT, SUBSTANCE ABUSE, COPING WITH CHRONIC CONDITIONS, AND MORE. IN 2022 THE BEHAVIORAL HEALTH PRACTICE PROVIDED 2,920 SERVICES. EYE CLINIC:SOUTHSIDE VISION PROVIDES A FULL-SERVICE EYE CLINIC PROVIDING PRIMARY CARE OPTOMETRY TO A DIVERSE POPULATION. ITS SERVICES INCLUDE EYE EXAMS, DISTANCE VISION, NEAR VISION, DEPTH PERCEPTIONS, COLOR PERCEPTION, MUSCLE BALANCE, EYE COORDINATION, DIAGNOSIS AND TREATMENT OF EYE DISEASE (E.G., PINK EYE AND ALLERGIES), FRAMES AND LENSES, AND CONTACT LENSES. IN 2022 THE VISION PRACTICE PROVIDED 1,590 VISITS. 8712783 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 34 0 133 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X JOHN PATRIKUS 6128212025 4243 FOURTH AVENUE SOUTH MINNEAPOLIS MN 55409 ANGEL EVEN CHAIR 1.00 X X 0 0 0 SHAUN ZEIG TREASURER 1.00 X X 0 0 0 JAMES GALLAGHER SECRETARY (THRU 07/2022) 1.00 X X 0 0 0 D'WAYNE MORRIS SECRETARY 1.00 X X 0 0 0 MABY ALMIRON DIRECTOR 1.00 X 0 0 0 EMILY ANDERSON DIRECTOR (THRU 05/2022) 1.00 X 0 0 0 KALEECA BIBLE DIRECTOR (THRU 03/2022) 1.00 X 0 0 0 MICHELLE EVANS DIRECTOR (THRU 07/2022) 1.00 X 0 0 0 KRISTY GRAUME DIRECTOR 1.00 X 0 0 0 YECTLI HUERTA DIRECTOR 1.00 X 0 0 0 JUAN LLERENA DIRECTOR 1.00 X 0 0 0 BRIAN OSBERG DIRECTOR 1.00 X 0 0 0 MARIKA REECE DIRECTOR 1.00 X 0 0 0 KATIE THOMPSON DIRECTOR 1.00 X 0 0 0 ANN CAZABAN EXECUTIVE DIRECTOR 40.00 X 187507 0 6542 MARK BUECHELE CHIEF FINANCIAL OFFICER 11.00 X 103421 0 0 MOHIUDDIN QUADRI DENTIST 40.00 X 147955 0 16237 JAMES ADAMCZAK DENTIST 40.00 X 155814 0 15987 DANIEL GINGERICH-BOBERG PHYSICIAN 40.00 X 129469 0 34413 JANELLE KARLSRUD DENTAL DIRECTOR 40.00 X 151754 0 6169 BRIAN QUINLAN DENTAL DIRECTOR 40.00 X 182349 0 16510 1058269 0 95858 15 0 1 0 GLORIMAR RIVERA 4243 FOURTH AVENUE SOUTH MINNEAPOLIS MN 55409 BILLING SERVICES 306109 OCHIN 1881 SW NAITO PARKWAY PORTLAND OR 97201 EMR/PRACTICE MANAGEMENT SYSTEM 280755 4RMULA 275 EAST 4TH STREET SUITE 400 ST PAUL MN 55101 ARCHITECTURAL/DESIGN SERVICES 232819 QUEST DIAGNOSTICS PO BOX 775460 CHICAGO IL 60677 REFERENCE LAB SERVICES 173445 LOFFLER PO BOX 1511 BIN 131511 MINNEAPOLIS MN 55480 IT SERVICES 119995 5 5854714 379242 6233956 DENTAL SERVICES 621400 3834520 3834520 MEDICAL SERVICES 621400 1360416 1360416 21018 21018 5215954 8279 8279 11458189 5215954 0 8279 X 297470 297470 5884823 5141427 743396 154390 129690 24700 336374 335143 1231 525867 440526 85341 6330 6330 25 25 366 366 64055 64055 1170047 482801 687246 14094 14094 405916 401550 4366 509087 489683 19404 265613 150043 115570 33180 7289 25891 118990 19668 99322 27829 3749 24080 396136 314452 81684 18898 7789 11109 PROGRAM SUPPLIES 446243 445703 540 BAD DEBT EXPENSE 178902 178902 MN PROVIDER TAXES 158600 158600 DUES & SUBSCRIPTIONS 18920 2439 16481 3329 3329 11035484 8712783 2258646 64055 500243 781492 1751754 2060033 0 142779 465193 443319 184073 65331 4674756 3351331 1205289 1323425 0 21515 4106552 4837894 622201 954864 458156 413668 0 20462 1080357 1388994 X 3026195 3448900 3026195 3448900 4106552 4837894 422705 0 X 0 1 X 1 1 1 X 3226004 4327833 5625759 5963359 6233956 25376911 3981110 5096391 3965507 5591309 5215954 23850271 7207114 9424224 9591266 11554668 11449910 49227182 0 0 0 49227182 1754 8279 10033 1754 8279 10033 48611 47489 18769 14625 129494 7255725 9471713 9610035 11571047 11458189 49366709 0.99720 0.99510 0.00020 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 366 366 0 PART II-B, LINE 1: 4% OF MNACHC MEMBERSHIP DUES FOR THE YEAR GO TOWARDS LOBBYING AND OTHER ADVOCACY ON BEHALF OF MEMBERS. THESE EFFORTS TEND TO ADVOCATE ON THE BEHALF OF THE MEMBERS THE STATE LEGISLATURE REGARDING THE MINNESOTA HEALTH DEPARTMENT FQHC SUBSIDY AND OTHER LEGISLATIVE ISSUES AROUND MEDICAID REIMBURSEMENT AS WELL AS OTHER TOPICS THAT IMPACT COMMUNITY HEALTH CENTERS IN THE STATE. 130543 130543 1289188 1029692 259496 315603 315603 0 2468312 2006036 462276 471110 471110 1323425 LEASE LIABILITY 20462 20462 X 11279287 -178902 -178902 11458189 0 11458189 10856582 0 10856582 178902 178902 11035484 PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -178,902. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 178,902. X X X X 1 BLASEG FUNDRAISING 8086 EAST LAKE CARLOS DRIVE NE CARLOS MN 56319 FUNDRAISING CONSULTING FOR CAPITAL CAMPAIGN FOR NEW BUILDING 0 0 45100 -45100 NONPROFIT FUNDRAISING PARTNERS LLC 1711 VAN HISE AVENUE MADISON WI 53726 FUNDRAISING CONSULTING FOR CAPITAL CAMPAIGN FOR NEW BUILDING 0 0 18955 -18955 64055 -64055 MN X X X 0 0 0 0 0 0 0 0 0 BRIAN QUINLAN DENTAL DIRECTOR 182349 0 0 0 0 0 6364 0 10146 0 198859 0 0 0 ANN CAZABAN EXECUTIVE DIRECTOR 187507 0 0 0 0 0 6350 0 192 0 194049 0 0 0 JAMES ADAMCZAK DENTIST 155814 0 0 0 0 0 6444 0 9543 0 171801 0 0 0 MOHIUDDIN QUADRI DENTIST 147955 0 0 0 0 0 6091 0 10146 0 164192 0 0 0 DANIEL GINGERICH-BOBERG PHYSICIAN 129469 0 0 0 0 0 0 0 34413 0 163882 0 0 0 JANELLE KARLSRUD DENTAL DIRECTOR 151754 0 0 0 0 0 6070 0 99 0 157923 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF FORM 990 IS PRESENTED TO THE EXECUTIVE COMMITTEE FOR REVIEW AND QUESTIONS. ONCE APPROVED BY THE COMMITTEE, FORM 990 WILL BE FILED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE UPDATED ANNUALLY FOR ALL BOARD MEMBERS AND EMPLOYEES. ANY CONFLICT OF INTEREST MUST BE IMMEDIATELY DISCLOSED TO THE EXECUTIVE DIRECTOR IN WRITING. NO MEMBER OF THE BOARD MAY VOTE ON MATTERS ON ANY AREA WHERE THEY MAY RECEIVE FINANCIAL GAIN, OR WHICH MAY CONFLICT WITH MEMBER OBLIGATIONS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR REVIEWS AND APPROVES THE COMPENSATION OF THE OTHER OFFICERS USING A MARKET SURVEY CONDUCTED BY AN OUTSIDE HR CONSULTANT. THE EXECUTIVE COMMITTEE USED EXECUTIVE SALARY SURVEYS FOR COMPARABILITY PURPOSES TO UPDATE THE EXECUTIVE DIRECTOR'S COMPENSATION. THE DECISION OF THE EXECUTIVE COMMITTEE WAS ALSO REVIEWED AND APPROVED BY THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 265,007. MANAGEMENT AND GENERAL EXPENSES 687,246. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 952,253. LAB FEES: PROGRAM SERVICE EXPENSES 217,794. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 217,794.