NATIVE AMERICAN COMMUNITY CLINIC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: NATIVE AMERICAN COMMUNITY CLINIC (EIN 03-0445789)
Tax period: 2020-01-01 to 2020-12-31
Filed: 2021-11-17
IRS object ID: 202113219349300601
Schema version: 2020v4.1
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule J
Schedule M
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-11-17T06:08:19-06:00	ReturnTs
Tax Period End	2020-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	410746749	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	220 S 6TH STREET SUITE 300	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55402	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	030445789	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NATIVE AMERICAN COMMUNITY CLINIC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	NATI	BusinessNameControlTxt
Phone	6128728086	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1213 E FRANKLIN AVENUE	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	554042923	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DR ANTONY STATELY	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	6128728086	PhoneNum
Signature	2021-11-16	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	DR	PersonFirstNm
Person Last	ANTONY STATELY	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	RYAN ENGEBRETSON	PreparerPersonNm
PTIN	P01585625	PTIN
Phone	6123764500	PhoneNum

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	DR ANTONY STATELY	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1213 E FRANKLIN AVENUE	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	554042923	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$9,109,228	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.NACC-HEALTHCARE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2002	FormationYr
Legal Domicile State	MN	LegalDomicileStateCd
Activity Or Mission	PROMOTE WELLNESS OF BODY, MIND & SPIRIT & REGULAR HEALTH MAINTENANCE IN NATIVE AMERICAN FAMILIES.	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	115	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$3,322,817	PYContributionsGrantsAmt
CY Contributions Grants	$5,530,356	CYContributionsGrantsAmt
PY Program Service Revenue	$3,817,137	PYProgramServiceRevenueAmt
CY Program Service Revenue	$3,573,761	CYProgramServiceRevenueAmt
PY Investment Income	$8,411	PYInvestmentIncomeAmt
CY Investment Income	$5,111	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$7,148,365	PYTotalRevenueAmt
CY Total Revenue	$9,109,228	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	$5,267,213	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$6,079,889	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$2,424,608	PYOtherExpensesAmt
CY Other Expenses	$2,960,203	CYOtherExpensesAmt
PY Total Expenses	$7,691,821	PYTotalExpensesAmt
CY Total Expenses	$9,040,092	CYTotalExpensesAmt
PY Revenues Less Expenses	-$543,456	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$69,136	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,287,567	TotalAssetsBOYAmt
Total Assets EOY	$4,996,334	TotalAssetsEOYAmt
Total Liabilities BOY	$680,865	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$2,320,496	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,606,702	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$2,675,838	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO PROMOTE WELLNESS AND REGULAR HEALTH MAINTENANCE IN NATIVE AMERICAN FAMILIES, TO DECREASE HEALTH DISPARITY IN THE NATIVE AMERICANS IN THE METRO AREA, AND TO PROVIDE ACCESS TO QUALITY CARE REGARDLESS OF ABILITY TO PAY.	MissionDesc
Significant New Program Srvc	Yes (1)	SignificantNewProgramSrvcInd
Significant Change	Yes (1)	SignificantChangeInd
Expense	$6,463,003	ExpenseAmt
Revenue	$3,355,000	RevenueAmt
Desc	PROVIDES MEDICAL AND DENTAL CARE, REGULAR HEALTH MAINTENANCE, AND COUNSELING SERVICES TO NATIVE AMERICAN FAMILIES AND PATIENTS. THE ORGANIZATION HAD 19,690 VISITS DURING 2020. IN ADDITION, THE ORGANIZATION PROVIDES CARE TO PATIENTS, WHO MEET CERTAIN CRITERIA UNDER THE ORGANIZATION'S CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE ORGANIZATION BELIEVES THE UNDERSERVED ARE THOSE PERSONS WHO ARE UNABLE THROUGH PRIVATE RESOURCES, EMPLOYER SUPPORT, OR PUBLIC AID TO PROVIDE PAYMENT FOR HEALTH CARE SERVICES OR THOSE UNABLE TO GAIN ACCESS TO HEALTH RELATED CARE BECAUSE OF LIMITED RESOURCES, INADEQUATE EDUCATION, OR DISCRIMINATION. BECAUSE THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS REVENUE.	Desc
Total Program Service Expenses	$6,463,003	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	0	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	Yes (1)	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	22	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	115	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	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
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	9	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	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
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JENNY SINGH	PersonNm
Phone	6128435995	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1213 EAST FRANKLIN AVENUE	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55404	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
PATINA PARK
BOARD CHAIR TIL 03/20	0.50	Yes (X)	Yes (X)	$0	$0	$0
JOSEPH HOBOT
BOARD CHAIR	0.50	Yes (X)	Yes (X)	$0	$0	$0
CAROL KRUSH
BOARD MEMBER	0.50	Yes (X)	Yes (X)	$0	$0	$0
B DON CROFUT
TREASURER	0.50	Yes (X)		$0	$0	$0
JEAN FORSTER
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
STEPHANIE GRAVES
SECRETARY	0.50	Yes (X)		$0	$0	$0
LYLE IRON MOCCASIN
VICE CHAIR	0.50	Yes (X)		$0	$0	$0
VALERIE LARSEN
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
ANNA YOUNGERMAN
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
ROBERT BLAKE
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
DR KARIE RABIE
CMO	40.00		Yes (X)	$218,279	$0	$22,559
DR ANTONY STATELY
CEO	40.00		Yes (X)	$184,008	$0	$23,787
SHERRY RINGBERG
INTERIM CFO	35.00		Yes (X)	$0	$0	$0
LAURELLE MYHRA
DIRECTOR OF BEHAVIORAL HEA	40.00		Yes (X)	$139,874	$0	$20,378
SHANNON FAHEY
CIO	40.00		Yes (X)	$122,720	$0	$19,390
JENEATTA SINGH
DIRECTOR OF FINANCE	40.00		Yes (X)	$96,362	$0	$15,645
GREGG HARRISON
COO	40.00		Yes (X)	$110,467	$0	$13,177
TARA MCCULLOUGH
NURSE PRACTIONER	40.00			$106,058	$0	$11,785	Yes (X)
TIMOTHY JANDRO
PSYCOLOGIST	40.00			$104,080	$0	$2,884	Yes (X)
PHONG NGUYEN
ADVANCED DENTAL THERAPIST	40.00			$104,246	$0	$8,030	Yes (X)
MARY RAUKER
MEDICAL DOCTOR	40.00			$100,287	$0	$108	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,286,381	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$137,743	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	9	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
NETGAIN
720 W ST GERMAIN ST 200	SAINT CLOUD	MN	56301	IT SERVICES AND EQUIPMENT	$192,596
FOX ADVANCEMENT
12501 HUNTINGDON LN	MINNETONKA	MN	55305	CAPITAL CAMPAIGN	$133,400

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	2	CntrctRcvdGreaterThan100KCnt
Government Grants	$4,941,666	GovernmentGrantsAmt
All Other Contributions	$588,690	AllOtherContributionsAmt
Noncash Contributions	$44,160	NoncashContributionsAmt
Total Contributions	$5,530,356	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PATIENT REVENUES	Desc
Business	621400	BusinessCd
Total Revenue Column	$3,355,000	TotalRevenueColumnAmt
Related Or Exempt Func Income	$3,355,000	RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$218,761	TotalRevenueColumnAmt
Exclusion	$218,761	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$3,573,761	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,111	TotalRevenueColumnAmt
Exclusion	$5,111	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$9,109,228	TotalRevenueColumnAmt
Related Or Exempt Func Income	$3,355,000	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$223,872	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,132,894	TotalAmt
Program Services	$259,255	ProgramServicesAmt
Management And General	$873,639	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$3,936,844	TotalAmt
Program Services	$3,477,921	ProgramServicesAmt
Management And General	$458,923	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$74,133	TotalAmt
Management And General	$74,133	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$600,914	TotalAmt
Program Services	$437,535	ProgramServicesAmt
Management And General	$163,379	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$335,104	TotalAmt
Program Services	$252,843	ProgramServicesAmt
Management And General	$82,261	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$120,853	TotalAmt
Management And General	$120,853	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$677,386	TotalAmt
Program Services	$375,881	ProgramServicesAmt
Management And General	$301,505	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$38,265	TotalAmt
Program Services	$36,014	ProgramServicesAmt
Management And General	$2,251	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$382,774	TotalAmt
Program Services	$179,136	ProgramServicesAmt
Management And General	$203,638	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,433	TotalAmt
Management And General	$1,433	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$500,703	TotalAmt
Program Services	$375,527	ProgramServicesAmt
Management And General	$125,176	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$131,208	TotalAmt
Program Services	$98,406	ProgramServicesAmt
Management And General	$32,802	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$31,902	TotalAmt
Program Services	$7,913	ProgramServicesAmt
Management And General	$23,989	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
PROGRAM & LAB SUPPLIES	$743,502	$743,502
REPAIRS AND MAINTENANCE	$165,926	$73,271	$92,655
CONTINUING EDUCATION	$83,300	$83,018	$282
MN CARE TAX	$41,563	$41,563

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$41,388	TotalAmt
Program Services	$21,218	ProgramServicesAmt
Management And General	$20,170	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$9,040,092	TotalAmt
Program Services	$6,463,003	ProgramServicesAmt
Management And General	$2,577,089	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$207,307	BOYAmt
EOY	$1,205,430	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,512,361	BOYAmt
EOY	$1,516,047	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,060,760	BOYAmt
EOY	$1,648,326	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$48,022	BOYAmt
EOY	$53,542	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$2,378,141	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,819,804	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$444,465	BOYAmt
EOY	$558,337	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$14,652	BOYAmt
EOY	$14,652	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,287,567	BOYAmt
EOY	$4,996,334	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$680,865	BOYAmt
EOY	$850,196	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
EOY	$400,000	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
EOY	$1,070,300	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$680,865	BOYAmt
EOY	$2,320,496	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	$2,606,702	BOYAmt
EOY	$2,675,838	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,606,702	BOYAmt
EOY	$2,675,838	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,287,567	BOYAmt
EOY	$4,996,334	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$69,136	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
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	$2,221,868	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,672,785	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,693,070	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$3,322,817	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,530,356	CurrentTaxYearAmt
Total	$16,440,896	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,221,868	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,672,785	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,693,070	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$3,322,817	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,530,356	CurrentTaxYearAmt
Total	$16,440,896	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total170	$16,440,896	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,520	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,659	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$6,165	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$8,411	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,111	CurrentTaxYearAmt
Total	$23,866	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$16,464,762	TotalSupportAmt
Gross Receipts Rltd Activities	$15,695,264	GrossReceiptsRltdActivitiesAmt
Public Support CY170	0.99860	PublicSupportCY170Pct
Public Support PY170	0.99850	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

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,285,047	OtherCostOrOtherBasisAmt
Depreciation	$983,345	DepreciationAmt
Book Value	$301,702	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,093,094	OtherCostOrOtherBasisAmt
Depreciation	$836,459	DepreciationAmt
Book Value	$256,635	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$558,337	TotalBookValueLandBuildingsAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$9,109,228	TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported	$0	RevenueNotReportedAmt
Revenue Subtotal	$9,109,228	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$9,109,228	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$9,040,092	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$9,040,092	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$9,040,092	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE FEDERAL INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX PROVISIONS. THE IMPLEMENTATION OF THE ACCOUNTING STANDARDS REGARDING UNCERTAIN TAX PROVISIONS HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
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 (3 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 KARIE RABIE
CMO	$218,279	$0	$0	$0	$0	$0	$0	$0	$22,559	$0	$240,838	$0	$0	$0
DR ANTONY STATELY
CEO	$184,008	$0	$0	$0	$0	$0	$0	$0	$23,787	$0	$207,795	$0	$0	$0
LAURELLE MYHRA
DIRECTOR OF BEHAVIORAL HEA	$139,874	$0	$0	$0	$0	$0	$0	$0	$20,378	$0	$160,252	$0	$0	$0

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	332	ContributionCnt
Noncash Contributions Rpt F990	$44,160	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FAIR MARKET VALUE	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	0	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 30B:	FormAndLineReferenceDesc
Explanation	SCHEDULE M, PART I, COLUMN (B): PART I REPORTS THE NUMBER OF CONTRIBUTIONS	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 2	PROVIDED COVID-19 TESTING AND VACCINES.
FORM 990, PART III, LINE 3	UNABLE TO PROVIDE DENTAL SERVICES FOR A PERIOD OF TIME AND ELIMATED THE STUDENT DENTAL MODEL.
FORM 990, PART VI, SECTION A, LINE 1	THE EXECUTIVE COMMITTEE IS COMPOSED OF THE OFFICERS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE AFFAIRS, DAY TO DAY OPERATIONS AND GENERAL BUSINESS OF THIS CORPORATION. THE EXECUTIVE COMMITTEE IS AT ALL TIMES SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD OF DIRECTORS AND PROVIDES REPORTS TO THE BOARD OF DIRECTORS AT ITS REGULAR MEETINGS AND AS THE BOARD OF DIRECTORS OTHERWISE DETERMINES. IF NO CEO IS EMPLOYED, THE EXECUTIVE COMMITTEE ASSUMES THE ROLES AND RESPONSIBILITIES OF THE CEO.
FORM 990, PART VI, SECTION A, LINE 3	THE ORGANIZATION CONTRACTED FLEX-ABLE SOLUTIONS, LLC TO PERFORM INTERIM CFO AND OTHER ACCOUNTING SERVICES. SHERRY RINGBERG RECEIVED COMPENSATION OF $171,745 FOR HER ROLE AS INTERIM CFO. THE ORGANIZATION PAID AN ADDITIONAL $3,332 TO FLEX-ABLE SOLUTIONS, LLC FOR OTHER ACCOUNTING SERVICES DURING THE YEAR.
FORM 990, PART VI, SECTION B, LINE 11B	BOTH THE MANAGEMENT AND BOARD OF DIRECTORS OF NATIVE AMERICAN COMMUNITY CLINIC REVIEWED THE FORM 990 PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS. IF A DIRECTOR HAS AN ACTUAL OR POTENTIAL CONFLICT, THEY ARE REQUIRED TO DISCLOSE THE MATERIAL FACTS TO THE BOARD OF DIRECTORS WHO DETERMINE IF A CONFLICT EXISTS. AN INTERESTED PERSON MAY NOT VOTE ON ANY MATTERS RELATED TO AN ACTUAL OR POTENTIAL CONFLICT. IN ADDITION, THE INTERESTED PERSON IS NOT COUNTED IN DETERMINING THE PRESENCE OF A QUORUM. THE MINUTES OF THE MEETING REFLECT THE DISCLOSURE MADE, THE INTERESTED PERSON'S ABSTENTION FROM VOTING, AND WHETHER A QUORUM WAS PRESENT.
FORM 990, PART VI, SECTION B, LINE 15	FOR OFFICERS, KEY EMPLOYEES AND HIGHEST PAID INDIVIDUALS, COMPENSATION WAS DETERMINED BY RESEARCHING THE RANGE OF SALARIES FOR COMPARABLE POSITIONS IN SIMILAR CLINICAL SETTINGS. COMPENSATION WAS BASED ON THE AVERAGE IN EACH SALARY RANGE. SINCE NATIVE AMERICAN COMMUNITY CLINIC IS A NOT-FOR-PROFIT ORGANIZATION, PHYSICIANS' SALARIES ARE BELOW-MARKET, BUT ARE IN LINE WITH COMPARABLE POSITIONS IN SIMILAR ORGANIZATIONS. BOARD APPROVAL FOR ALL EMPLOYEES WAS BASED ON RESEARCH FINDINGS AND NATIVE AMERICAN COMMUNITY CLINIC BUDGET ALLOWANCE. THIS RESEARCH WAS LAST PERFORMED IN 2019.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.