MIDTOWN HEALTH CENTER INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- MIDTOWN HEALTH CENTER INC (EIN 47-0833378)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-03-09
- IRS object ID
- 202240689349300739
- Schema version
- 2020v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-03-09T13:51:52-06:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 470677245 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HBE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7140 STEPHANIE LANE PO BOX 23110 | AddressLine1Txt |
| City | LINCOLN | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 685423110 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470833378 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDTOWN HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MIDT | BusinessNameControlTxt |
| Phone | 4023718000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 302 W PHILLIP AVE | AddressLine1Txt |
| City | NORFOLK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68701 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KATHLEEN NORDBY | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 4023718000 | PhoneNum |
| Signature | 2022-02-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KATHLEEN | PersonFirstNm |
| Person Last | NORDBY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PATRICK A MEYER CPA CFE | PreparerPersonNm |
| PTIN | P00283870 | PTIN |
| Phone | 4024234343 | PhoneNum |
| Preparation | 2022-02-17 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KATHLEEN NORDBY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 302 W PHILLIP AVE | AddressLine1Txt |
| City | NORFOLK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,384,392 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MIDTOWNHEALTHNE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HIGH QUALITY MEDICAL, BEHAVIORAL HEALTH, AND DENTAL SERVICES THAT ARE AFFORDABLE, ACCESSIBLE, AND PATIENT-FOCUSED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 132 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,282,830 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,581,786 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,802,428 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,769,561 | CYProgramServiceRevenueAmt |
| PY Investment Income | $19,189 | PYInvestmentIncomeAmt |
| CY Investment Income | $18,759 | CYInvestmentIncomeAmt |
| PY Other Revenue | $30,759 | PYOtherRevenueAmt |
| CY Other Revenue | $14,286 | CYOtherRevenueAmt |
| PY Total Revenue | $8,135,206 | PYTotalRevenueAmt |
| CY Total Revenue | $11,384,392 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,104,545 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,771,883 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $64,769 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,360,307 | PYOtherExpensesAmt |
| CY Other Expenses | $2,516,782 | CYOtherExpensesAmt |
| PY Total Expenses | $7,464,852 | PYTotalExpensesAmt |
| CY Total Expenses | $8,288,665 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $670,354 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,095,727 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,258,100 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,798,512 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,599,459 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,813,007 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,658,641 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,985,505 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE HIGH QUALITY MEDICAL, BEHAVIORAL HEALTH, AND DENTAL SERVICES THAT ARE AFFORDABLE, ACCESSIBLE, AND PATIENT-FOCUSED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,347,846 | ExpenseAmt |
| Revenue | $4,769,561 | RevenueAmt |
| Desc | 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 2020, WE SAW 7,030 INDIVIDUALS REPRESENTING A 1% DECREASE FROM 2019 FOR A TOTAL OF 21,327 ENCOUNTERS. 31.95% PERCENT OF OUR PATIENTS DID NOT HAVE INSURANCE, 33.38% WERE ENROLLED IN EITHER MEDICAID OR MEDICARE AS THEIR THIRD PARTY PAYOR, 30.47% OF THE PATIENTS HAD INCOME BELOW THE 100% POVERTY GUIDELINE WITH A FULL 65.4% OF OUR PATIENTS DECLARING THEMSELVES AND THEIR HOUSEHOLD TO BE AT OR BELOW 200% OF POVERTY. | Desc |
| Total Program Service Expenses | $6,347,846 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 132 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KATHY NORDBY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4023718000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 302 W PHILLIP AVE | AddressLine1Txt |
| City | NORFOLK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68701 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| BETTY FROEHLICH | |||||||
| BOARD CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ALAN EHLERS | |||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| WILL PERRIGAN | |||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LANCE MORROW | |||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GRETCHEN FORSELL | |||||||
| PAST CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BRENDA JONES | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARY LUHR | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN LUTZ | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOE MTIKA | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT SMITH | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KAREN WEIDNER | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN WARNEKE | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KATRIN LIMONTA | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHLEEN NORDBY | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $124,575 | $0 | $11,645 | ||
| LINDA ANDERSON | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $18,840 | $0 | $1,098 | ||
| TERRI FORD-WOLFGRAM | |||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $118,962 | $0 | $3,446 | ||
| DR EMILY VUCHETICH | |||||||
| PEDIATRICIAN | 40.00 | $263,302 | $0 | $29,375 | Yes (X) | ||
| DR RAYMOND HELLER | |||||||
| PHYSICIAN | 32.00 | $229,879 | $0 | $9,139 | Yes (X) | ||
| DR DAVID SEGER | |||||||
| DENTIST | 40.00 | $165,509 | $0 | $6,745 | Yes (X) | ||
| DR RACHEL WADE | |||||||
| DENTIST | 40.00 | $139,968 | $0 | $5,536 | Yes (X) | ||
| DR LOISKA SIVAGANESHAN | |||||||
| PHYSICIAN | 36.00 | $183,914 | $0 | $6,347 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,244,949 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $73,331 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,184,964 | GovernmentGrantsAmt |
| All Other Contributions | $396,822 | AllOtherContributionsAmt |
| Total Contributions | $6,581,786 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621110 | $4,606,631 | $4,606,631 |
| CONTRACT REVENUE | 621110 | $162,930 | $162,930 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,769,561 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,759 | TotalRevenueColumnAmt |
| Exclusion | $18,759 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $14,286 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $14,286 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,286 | TotalRevenueColumnAmt |
| Exclusion | $14,286 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,384,392 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,769,561 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $33,045 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $431,400 | TotalAmt |
| Management And General | $431,400 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,498,056 | TotalAmt |
| Program Services | $3,422,537 | ProgramServicesAmt |
| Management And General | $1,026,627 | ManagementAndGeneralAmt |
| Fundraising | $48,892 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,997 | TotalAmt |
| Program Services | $143,969 | ProgramServicesAmt |
| Management And General | $31,971 | ManagementAndGeneralAmt |
| Fundraising | $2,057 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,444 | TotalAmt |
| Program Services | $228,821 | ProgramServicesAmt |
| Management And General | $82,353 | ManagementAndGeneralAmt |
| Fundraising | $3,270 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,986 | TotalAmt |
| Program Services | $244,992 | ProgramServicesAmt |
| Management And General | $101,495 | ManagementAndGeneralAmt |
| Fundraising | $3,499 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,566 | TotalAmt |
| Management And General | $9,566 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,679 | TotalAmt |
| Program Services | $39,679 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $624,308 | TotalAmt |
| Program Services | $624,308 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,072 | TotalAmt |
| Program Services | $45,111 | ProgramServicesAmt |
| Management And General | $5,307 | ManagementAndGeneralAmt |
| Fundraising | $2,654 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $390,559 | TotalAmt |
| Program Services | $327,756 | ProgramServicesAmt |
| Management And General | $62,038 | ManagementAndGeneralAmt |
| Fundraising | $765 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,875 | TotalAmt |
| Program Services | $95,906 | ProgramServicesAmt |
| Management And General | $30,690 | ManagementAndGeneralAmt |
| Fundraising | $1,279 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,793 | TotalAmt |
| Program Services | $1,815 | ProgramServicesAmt |
| Management And General | $978 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,268 | TotalAmt |
| Program Services | $24,214 | ProgramServicesAmt |
| Management And General | $6,054 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,991 | TotalAmt |
| Program Services | $46,461 | ProgramServicesAmt |
| Management And General | $7,530 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,291 | TotalAmt |
| Program Services | $176,468 | ProgramServicesAmt |
| Management And General | $56,470 | ManagementAndGeneralAmt |
| Fundraising | $2,353 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,589 | TotalAmt |
| Program Services | $29,589 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DENTAL, MEDICAL & PHARM | $629,840 | $629,840 | |
| ASSOCIATION DUES | $135,715 | $124,858 | $10,857 |
| REPAIRS AND MAINTENANCE | $65,007 | $58,506 | $6,501 |
| VEHICLE EXPENSES | $39,372 | $38,191 | $1,181 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,857 | TotalAmt |
| Program Services | $44,825 | ProgramServicesAmt |
| Management And General | $5,032 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,288,665 | TotalAmt |
| Program Services | $6,347,846 | ProgramServicesAmt |
| Management And General | $1,876,050 | ManagementAndGeneralAmt |
| Fundraising | $64,769 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,785,418 | BOYAmt |
| EOY | $136,980 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $190,400 | BOYAmt |
| EOY | $3,873,679 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $525,915 | BOYAmt |
| EOY | $763,824 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $529,019 | BOYAmt |
| EOY | $591,692 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $602 | BOYAmt |
| EOY | $181,227 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,571,300 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,076,560 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,213,089 | BOYAmt |
| EOY | $3,494,740 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,657 | BOYAmt |
| EOY | $6,370 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $750,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,258,100 | BOYAmt |
| EOY | $9,798,512 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $618,822 | BOYAmt |
| EOY | $711,548 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,951,478 | BOYAmt |
| EOY | $141,357 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,029,159 | BOYAmt |
| EOY | $960,102 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,599,459 | BOYAmt |
| EOY | $1,813,007 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,658,641 | BOYAmt |
| EOY | $7,985,505 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,658,641 | BOYAmt |
| EOY | $7,985,505 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,258,100 | BOYAmt |
| EOY | $9,798,512 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,095,727 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $231,137 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,294,277 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,679,085 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,647,059 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,282,830 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,581,786 | CurrentTaxYearAmt |
| Total | $22,485,037 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,294,277 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,679,085 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,647,059 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,282,830 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,581,786 | CurrentTaxYearAmt |
| Total | $22,485,037 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $22,485,037 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $27,394 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,120 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,640 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,189 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,759 | CurrentTaxYearAmt |
| Total | $110,102 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,500 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,039 | CurrentTaxYearMinus3YearsAmt |
| Total | $8,539 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $22,603,678 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $11,756,189 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99480 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99370 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $93,269 | OtherCostOrOtherBasisAmt |
| Book Value | $93,269 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,361,495 | OtherCostOrOtherBasisAmt |
| Depreciation | $521,573 | DepreciationAmt |
| Book Value | $2,839,922 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,116,536 | OtherCostOrOtherBasisAmt |
| Depreciation | $554,987 | DepreciationAmt |
| Book Value | $561,549 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,494,740 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEPOSIT | Desc |
| Book Value | $750,000 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $750,000 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $11,384,392 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,384,392 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,384,392 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $8,288,665 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $8,288,665 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $8,288,665 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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, 2021, 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR EMILY VUCHETICH | ||||||||||||||
| PEDIATRICIAN | $192,853 | $0 | $70,449 | $0 | $0 | $0 | $10,968 | $0 | $18,407 | $0 | $292,677 | $0 | $0 | $0 |
| DR RAYMOND HELLER | ||||||||||||||
| PHYSICIAN | $227,974 | $0 | $1,905 | $0 | $0 | $0 | $9,139 | $0 | $0 | $0 | $239,018 | $0 | $0 | $0 |
| DR LOISKA SIVAGANESHAN | ||||||||||||||
| PHYSICIAN | $183,414 | $0 | $500 | $0 | $0 | $0 | $0 | $0 | $6,347 | $0 | $190,261 | $0 | $0 | $0 |
| DR DAVID SEGER | ||||||||||||||
| DENTIST | $163,448 | $0 | $2,061 | $0 | $0 | $0 | $6,745 | $0 | $0 | $0 | $172,254 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |