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COOK AREA HEALTH SERVICES INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
COOK AREA HEALTH SERVICES INC (EIN 41-1344385)
Tax period
2022-06-01 to 2023-05-31
Filed
2023-12-11
IRS object ID
202303459349300435
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-12-11T09:58:53-08:00ReturnTs
Tax Period End2023-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN463893925PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Walker Giroux & Hahne LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1225 1st Street N Suite 2400AddressLine1Txt
CityVirginiaCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55792ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411344385EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COOK AREA HEALTH SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOOKBusinessNameControlTxt
Phone2183613127PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line120 FIFTH STREET SEAddressLine1Txt
CityCOOKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55723ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEITH HARVEYPersonNm
Person TitleCFOPersonTitleTxt
Signature2023-12-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstKEITHPersonFirstNm
Person LastHARVEYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonThomas KellyPreparerPersonNm
PTINP01240546PTIN
Phone2187494880PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

US Address USAddress

FieldValueIRS element (for citing)
Address Line120 FIFTH STREET SEAddressLine1Txt
CityCOOKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55723ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$18,771,024GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1979FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO PROVIDE MEDICAL, DENTAL & SUPPORTIVE SERVICES IN A REMOTE,RURAL AREA OF NORTHERN MINNESOTA. AS A FEDERALLY QUALIFIED HEALTH CENTER IN A REMOTE, RURAL AREA IT IS OUR GOAL TO BE CUSTOMER FOCUSED WITHOUT REGARD TO ECONOMIC STATUS OR ANY OTHER ARTIFICIAL BARRIER.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee185TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$5,316,364PYContributionsGrantsAmt
CY Contributions Grants$5,149,911CYContributionsGrantsAmt
PY Program Service Revenue$12,104,564PYProgramServiceRevenueAmt
CY Program Service Revenue$13,621,109CYProgramServiceRevenueAmt
PY Investment Income$2PYInvestmentIncomeAmt
CY Investment Income$4CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$17,420,930PYTotalRevenueAmt
CY Total Revenue$18,771,024CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,276,360PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$12,791,817CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,962,053PYOtherExpensesAmt
CY Other Expenses$5,484,128CYOtherExpensesAmt
PY Total Expenses$17,238,413PYTotalExpensesAmt
CY Total Expenses$18,275,945CYTotalExpensesAmt
PY Revenues Less Expenses$182,517PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$495,079CYRevenuesLessExpensesAmt
Total Assets BOY$6,423,593TotalAssetsBOYAmt
Total Assets EOY$6,599,123TotalAssetsEOYAmt
Total Liabilities BOY$1,994,425TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,674,876TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,429,168NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,924,247NetAssetsOrFundBalancesEOYAmt
MissionOUR MISSION IS TO PROVIDE MEDICAL, DENTAL & SUPPORTIVE SERVICES IN A REMOTE, RURAL AREA OF NORTHERN MINNESOTA. AS A FEDERALLY QUALIFIED HEALTH CENTER IN A REMOTE, RURAL AREA, IT IS OUR GOAL TO BE CUSTOMER FOCUSED WITHOUT REGARD TO ECONOMIC STATUS OR ANY OTHER ARTIFICIAL BARRIER. WE INTEND TO PROVIDE QUALITY PRIMARY CARE THAT MEETS THE NEEDS OF PEOPLE IN OUR DESIGNATED SERVICE AREA THROUGH COLLABORATIVE EFFORTS WITH CRITICAL ACCESS HOSPITALS, CARE CENTERS, SPECIALISTS, ASSOCIATIONS, FOUNDATIONS AND OTHER APPROPRIATE OR AVAILABLE OPPORTUNITIES. OUR CORE VALUE IS THE CARE OF FAMILIES, FRIENDS AND VISITORS WHO RESIDE IN OR TRAVEL THROUGH OUR REGION BY ASSISTING TO IMPROVE THEIR HEALTH. THIS CARE IS PROVIDED AT OUR MEDICAL CLINICS IN BIGFORK, BIG FALLS, COOK, FLOODWOOD,NORTHOME, AND TOWER MN AND AT OUR DENTAL CLINICS IN COOK, FLOODWOOD, AND TOWER, MN. CARE IS ALSO PROVIDED THROUGH CONTRACTS WITH BIGFORK VALLEY AND COOK HOSPITALS AND THEIR ASSOCIATED NURSING HOMES AS WELL AS AT NORTHOME CAREMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$13,127,193ExpenseAmt
DescPROVIDE MEDICAL SERVICES, 31,392 ENCOUNTERSDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
DescPROVIDE DENTAL SERVICES, 16,321 ENCOUNTERSDesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
DescPROVIDE OTHER HEALTH SERVICES, 3,325 ENCOUNTERSDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$13,127,193TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document19IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee185EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKEITH HARVEYPersonNm
Phone2183613135PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line120 FIFTH STREET SEAddressLine1Txt
CityCOOKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55723ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
ERIC ELLEBY
PHYSICIAN40.000.00$403,165$0$18,990
NICHOLAS VIDOR
PHYSICIAN40.000.00$334,017$0$10,700
MATTHEW HOLMES
PHYSICIAN40.000.00$318,100$0$18,990
BARRET MYERS WOLFSON
PHYSICIAN40.000.00$277,010$0$30,265
ERIC SCRIVNER
PHYSICIAN40.000.00$270,766$0$29,665
MICHAEL HOLMES
CEO40.000.00$131,044$0$6,102Yes (X)
KEITH HARVEY
CFO40.000.00$113,393$0$14,163Yes (X)
ROBIN HARKONEN
Director1.000.00$0$0$0Yes (X)
WENDE NELSON
Vice President1.000.00$0$0$0Yes (X)Yes (X)
GAIL BLACKMER
SEC'Y/TREASURER1.500.00$0$0$0Yes (X)Yes (X)
LIZ STORM
Director1.000.00$0$0$0Yes (X)
KAREN LORENZEN
Director1.000.00$0$0$0Yes (X)
RICHARD HANSON
Director1.000.00$0$0$0Yes (X)
MARIAN SWANG
Director1.000.00$0$0$0Yes (X)
ROBERT WALKER
DIRECTOR1.000.00$0$0$0Yes (X)
WILLIAM H TIBBETTS
President2.000.00$0$0$0Yes (X)Yes (X)
THOMAS MORNEAU
Director1.000.00$0$0$0Yes (X)
MARCI MAPLE
Director1.000.00$0$0$0Yes (X)
JOEL KARELS
DIRECTOR1.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,847,495TotalReportableCompFromOrgAmt
Total Other Compensation$128,875TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K7IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
NATIONAL MEDICAL RESOURCES
2792 E BROADWAY AVEBISMARCKND58501LOCUM PHSYICIAN COVERAGE$381,969
PATTERSON DENTAL SUPPLY
28244 NETWORK PLACECHICAGOIL60673DENTAL SUPPLIES$297,456
BIGFORK VALLEY HOSPITAL
PO BOX 258BIGFORKMN56628LEASES/LABS$231,559
BREAKWATER HEALTH NETWORK
1324 ARROWHEAD RD STE 332DULUTHMN55811CLINICAL/BUS/PAT SVC$471,558
MCKESSON MEDICAL
PO BOX 634404CINCINNATIOH45263MEDICAL SUPPLIES$303,695
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Government Grants$5,149,911GovernmentGrantsAmt
Total Contributions$5,149,911TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescMEDICAL & DENTAL REVENUEDesc
Business621110BusinessCd
Total Revenue Column$13,621,109TotalRevenueColumnAmt
Related Or Exempt Func Income$13,621,109RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$13,621,109TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4TotalRevenueColumnAmt
Exclusion$4ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,771,024TotalRevenueColumnAmt
Related Or Exempt Func Income$13,621,109RelatedOrExemptFuncIncomeAmt
Exclusion$4ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$266,404TotalAmt
Management And General$266,404ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,281,762TotalAmt
Program Services$7,807,974ProgramServicesAmt
Management And General$2,473,788ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$339,317TotalAmt
Program Services$257,323ProgramServicesAmt
Management And General$81,994ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,199,134TotalAmt
Program Services$900,507ProgramServicesAmt
Management And General$298,627ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$705,200TotalAmt
Program Services$523,258ProgramServicesAmt
Management And General$181,942ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$25,000TotalAmt
Management And General$25,000ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,347,627TotalAmt
Program Services$959,020ProgramServicesAmt
Management And General$388,607ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,530,031TotalAmt
Program Services$1,239,436ProgramServicesAmt
Management And General$290,595ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$845,112TotalAmt
Program Services$5,114ProgramServicesAmt
Management And General$839,998ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$741,436TotalAmt
Program Services$718,800ProgramServicesAmt
Management And General$22,636ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$113,229TotalAmt
Program Services$80,532ProgramServicesAmt
Management And General$32,697ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$103,361TotalAmt
Program Services$97,299ProgramServicesAmt
Management And General$6,062ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$68,210TotalAmt
Program Services$54,376ProgramServicesAmt
Management And General$13,834ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$98,399TotalAmt
Program Services$72,843ProgramServicesAmt
Management And General$25,556ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
RECRUITMENT$201,647$635$201,012
DENTAL LABORATORY$191,129$191,129
OSHA COMPLIANCE AND SAFETY$133,893$133,893
BAD DEBT EXPENSE$85,054$85,054

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,275,945TotalAmt
Program Services$13,127,193ProgramServicesAmt
Management And General$5,148,752ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,728,039BOYAmt
EOY$1,996,747EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,109BOYAmt
EOY$2,115EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$98,203BOYAmt
EOY$21,988EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,244,873BOYAmt
EOY$1,243,749EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$162,079BOYAmt
EOY$132,632EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,324,025LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,224,042LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,188,290BOYAmt
EOY$3,099,983EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$101,909EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,423,593BOYAmt
EOY$6,599,123EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,577,733BOYAmt
EOY$1,182,265EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$416,692BOYAmt
EOY$390,702EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$101,909EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,994,425BOYAmt
EOY$1,674,876EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,429,168BOYAmt
EOY$4,924,247EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,429,168BOYAmt
EOY$4,924,247EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,423,593BOYAmt
EOY$6,599,123EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$495,079ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteefalseAuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,717,466CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,982,571CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,307,918CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,316,364CurrentTaxYearMinus1YearAmt
Current Tax Year$5,149,911CurrentTaxYearAmt
Total$24,474,230TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,717,466CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,982,571CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,307,918CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,316,364CurrentTaxYearMinus1YearAmt
Current Tax Year$5,149,911CurrentTaxYearAmt
Total$24,474,230TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$24,474,230PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2CurrentTaxYearMinus1YearAmt
Current Tax Year$4CurrentTaxYearAmt
Total$15TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-$71,694CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus2 Years$1,606,732CurrentTaxYearMinus2YearsAmt
Total$1,535,038TotalAmt
FieldValueIRS element (for citing)
Total Support$26,009,283TotalSupportAmt
Gross Receipts Rltd Activities$56,480,366GrossReceiptsRltdActivitiesAmt
Public Support CY1700.94100PublicSupportCY170Pct
Public Support PY1700.93600PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,500OtherCostOrOtherBasisAmt
Book Value$19,500BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,012,062OtherCostOrOtherBasisAmt
Depreciation$1,092,826DepreciationAmt
Book Value$1,919,236BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,778,130OtherCostOrOtherBasisAmt
Depreciation$893,090DepreciationAmt
Book Value$885,040BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,508,453OtherCostOrOtherBasisAmt
Depreciation$1,238,126DepreciationAmt
Book Value$270,327BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,880OtherCostOrOtherBasisAmt
Book Value$5,880BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,099,983TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLEASE LIABILITYDesc
Amt$101,909Amt
FieldValueIRS element (for citing)
Total Liability$101,909TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$18,771,024TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$18,771,024RevenueSubtotalAmt
Total Revenue Per Form990$18,771,024TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$18,275,945TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$18,275,945ExpensesSubtotalAmt
Total Expenses Per Form990$18,275,945TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
BARRET MYERS WOLFSON
PHYSICIAN$277,010$8,616$21,649$307,275
ERIC ELLEBY
PHYSICIAN$403,165$8,700$10,290$422,155
ERIC SCRIVNER
PHYSICIAN$270,766$8,016$21,649$300,431
MATTHEW HOLMES
PHYSICIAN$318,100$8,700$10,290$337,090
NICHOLAS VIDOR
PHYSICIAN$334,017$8,700$2,000$344,717

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonDR MATTHEW HOLMESPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionCEO'S SONRelationshipDescriptionTxt
Transaction$338,992TransactionAmt
TransactionWAGES AND BENEFITSTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, Line 11bTHE 990 IS PROVIDED TO THE BOARD OF DIRECTORS UPON RECEIPT FROM THE PREPARER. THE COPY WAS INCLUDED WITH THE STANDARD MATERIALS (MEETING MINUTES, FINANCIAL REPORTS, ETC.) PROVIDED TO THE BOARD PRIOR TO THEIR MONTHLY MEETING.
Form 990, Part VI, Section B, Line 12cCAHS REQUIRES ANNUAL REPORTING FROM ALL DIRECTORS AND KEY EMPLOYEES REGARDING ANY CONFLICTS OF INTEREST WITH RELATED ORGANIZATIONS AND VENDORS WITH WHOM THE ORGANIZATION TRANSACTS BUSINESS. CAHS MONITORS DISCLOSURES PROVIDED TO ANY AFFIRMATIVE REPONSES.
Form 990, Part VI, Section B, Line 15aTHE BOARD'S FINANCE COMMITTEE CONDUCTS AN ANNUAL COMPENSATION REVIEW OF CAHS KEY EMPLOYEES USING SALARY SURVEYS FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, THE MN DEPT. OF EMPLOYMENT AND ECONOMIC DEVELOPMENT, AND OTHER AVAILABLE SALARY SURVEYS. THE COMMITTEE DOCUMENTS EACH EMPLOYEE'S COMPENSATION RELATIVE TO SURVEY DATA AND SUBSTANTIATES REASONS FOR SUBSTANTIAL VARIANCES FROM AVAILABLE DATA.
Form 990, Part VI, Section B, Line 15bTHE BOARD'S FINANCE COMMITTEE CONDUCTS AN ANNUAL COMPENSATION REVIEW OF CAHS KEY EMPLOYEES USING SALARY SURVEYS FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, THE MN DEPT. OF EMPLOYMENT AND ECONOMIC DEVELOPMENT, AND OTHER AVAILABLE SALARY SURVEYS. THE COMMITTEE DOCUMENTS EACH EMPLOYEE'S COMPENSATION RELATIVE TO SURVEY DATA AND SUBSTANTIATES REASONS FOR SUBSTANTIAL VARIANCES FROM AVAILABLE DATA.
Form 990, Part VI, Section C, Line 19NO DOCUMENTS AVAILABLE TO THE PUBLIC.