SCENIC BLUFFS HEALTH CENTER INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- SCENIC BLUFFS HEALTH CENTER INC (EIN 39-1760445)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2020-12-21
- IRS object ID
- 202033569349300528
- Schema version
- 2019v5.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-12-21T11:49:14-06:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390974031 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEGNER CPAS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2921 LANDMARK PL STE 300 | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 537134236 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391760445 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCENIC BLUFFS HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SCEN | BusinessNameControlTxt |
| Phone | 6086545100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 238 FRONT ST | AddressLine1Txt |
| City | CASHTON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 546192002 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARI FREIBERG | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 6086545100 | PhoneNum |
| Signature | 2020-12-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JASON STEPHENS CPA | PreparerPersonNm |
| PTIN | P01263225 | PTIN |
| Phone | 6082744020 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARI FREIBERG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 238 FRONT ST | AddressLine1Txt |
| City | CASHTON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 546192002 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,487,251 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SCENICBLUFFS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | SCENIC BLUFFS HEALTH CENTER IS AN INDEPENDENT, NON-PROFIT, COMMUNITY-BASED PRIMARY CARE SERVICE PROVIDER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 97 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,172,991 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,517,901 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,544,914 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,906,255 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$55,152 | PYInvestmentIncomeAmt |
| CY Investment Income | $25,330 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $37,765 | CYOtherRevenueAmt |
| PY Total Revenue | $6,662,753 | PYTotalRevenueAmt |
| CY Total Revenue | $6,487,251 | 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 | $4,749,451 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,929,586 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,119,274 | PYOtherExpensesAmt |
| CY Other Expenses | $2,136,257 | CYOtherExpensesAmt |
| PY Total Expenses | $6,868,725 | PYTotalExpensesAmt |
| CY Total Expenses | $7,065,843 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$205,972 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$578,592 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,300,116 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,948,915 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,959,474 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,186,865 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,340,642 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,762,050 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | DELIVERING ACCESSIBLE PATIENT-CENTERED PRIMARY CARE, SUPPORTING HEALTHIER PEOPLE AND COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,452,009 | ExpenseAmt |
| Revenue | $3,906,255 | RevenueAmt |
| Desc | SCENIC BLUFFS, RECOGNIZED AS A PATIENT-CENTERED MEDICAL HOME (PCMH) BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE, PROVIDES PRIMARY, PREVENTIVE HEALTHCARE TO THE UNDERSERVED POPULATIONS OF MONROE, VERNON, CRAWFORD AND LA CROSSE COUNTIES IN WESTERN WISCONSIN. IN 2019, WE SERVED 7,602 PATIENTS WITH A TOTAL OF 23,664 APPOINTMENTS. OF THESE APPOINTMENTS, 31% WERE MEDICAL, 53% WERE DENTAL, 5% WERE COMPLEMENTARY MEDICINE, 11% WERE BEHAVIORAL HEALTH, AND MANY PATIENTS RECEIVED HEALTH EDUCATION AND PHARMACY SERVICES. SCENIC BLUFFS AIMS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH THROUGH EDUCATIONAL, PREVENTION-BASED PROGRAMMING THAT CONNECTS PATIENTS WITH RESOURCES AND EDUCATION. THIS IS POSSIBLE THROUGH OUR HEALTH EDUCATORS, HELP TEAM, CERTIFIED APPLICATION COUNSELOR, AND OUR ENGAGEMENT IN NEARLY 50 COMMUNITY COALITIONS AND BOARDS. | Desc |
| Total Program Service Expenses | $5,452,009 | 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 | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 97 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHERYL ROBINSON | PersonNm |
| Phone | 6086545100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 238 FRONT STREET | AddressLine1Txt |
| City | CASHTON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 546192002 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ANN KLINKNER | ||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BECKY GRETEBECK | ||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SARA COOK | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MELVIN SCHMITZ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HETTI BROWN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| EMILY HAYES | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JUDI ZABEL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KARINE BRUEGGEN | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER RHUDY | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LEE NERISON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARI FREIBERG | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $165,930 | $0 | $17,699 | |||
| SHERYL ROBINSON | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $117,754 | $0 | $12,143 | |||
| ELIZABETH BADE | ||||||||
| MEDICAL DIRECTOR | 40.00 | $208,801 | $0 | $18,239 | Yes (X) | |||
| JAMES SUEPPEL | ||||||||
| DENTIST | 40.00 | $191,366 | $0 | $17,396 | Yes (X) | |||
| BRENT PARKER | ||||||||
| DENTIST | 40.00 | $157,020 | $0 | $9,908 | Yes (X) | |||
| MARK HEBERLEIN | ||||||||
| PHYSICIAN | 40.00 | $214,483 | $0 | $11,415 | Yes (X) | |||
| SUSAN ADAMS | ||||||||
| PHARMACIST | 40.00 | $136,438 | $0 | $9,500 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,191,792 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $96,300 | 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 |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ECLINICALWORKS | |||||
| TWO TECHNOLOGY DRIVE | WESTBOROUGH | MA | 01581 | EHR LICENSING AND RELATED SUPPORT SERVIC | $125,474 |
| WIPFLI LLP | |||||
| 4890 OWEN AYRES COURT STE 200 | EAU CLAIRE | WI | 54701 | TECHNOLOGY SUPPORT | $110,524 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $50,296 | FederatedCampaignsAmt |
| Government Grants | $2,322,086 | GovernmentGrantsAmt |
| All Other Contributions | $145,519 | AllOtherContributionsAmt |
| Noncash Contributions | $4,000 | NoncashContributionsAmt |
| Total Contributions | $2,517,901 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621498 | $3,771,467 | $3,771,467 |
| CONTRACT SERVICES | 621498 | $134,788 | $134,788 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,906,255 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,330 | TotalRevenueColumnAmt |
| Exclusion | $25,330 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,780 | 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 | $11,780 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,780 | TotalRevenueColumnAmt |
| Exclusion | $11,780 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,985 | TotalRevenueColumnAmt |
| Exclusion | $25,985 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $25,985 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,487,251 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,906,255 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $63,095 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $578,206 | TotalAmt |
| Program Services | $172,239 | ProgramServicesAmt |
| Management And General | $405,967 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,610,261 | TotalAmt |
| Program Services | $2,863,842 | ProgramServicesAmt |
| Management And General | $746,419 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,231 | TotalAmt |
| Program Services | $87,802 | ProgramServicesAmt |
| Management And General | $32,429 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,612 | TotalAmt |
| Program Services | $264,116 | ProgramServicesAmt |
| Management And General | $66,496 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,276 | TotalAmt |
| Program Services | $211,983 | ProgramServicesAmt |
| Management And General | $78,293 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,570 | TotalAmt |
| Management And General | $9,570 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,925 | TotalAmt |
| Management And General | $13,925 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $356,752 | TotalAmt |
| Program Services | $340,888 | ProgramServicesAmt |
| Management And General | $15,864 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,039 | TotalAmt |
| Program Services | $35,039 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,175 | TotalAmt |
| Program Services | $175,762 | ProgramServicesAmt |
| Management And General | $21,413 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,571 | TotalAmt |
| Program Services | $243,034 | ProgramServicesAmt |
| Management And General | $54,537 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,642 | TotalAmt |
| Program Services | $105,687 | ProgramServicesAmt |
| Management And General | $7,955 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,236 | TotalAmt |
| Program Services | $29,131 | ProgramServicesAmt |
| Management And General | $105 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,243 | TotalAmt |
| Program Services | $29,243 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,098 | TotalAmt |
| Program Services | $50,049 | ProgramServicesAmt |
| Management And General | $50,049 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $338,324 | TotalAmt |
| Program Services | $243,328 | ProgramServicesAmt |
| Management And General | $94,996 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,314 | TotalAmt |
| Program Services | $18,498 | ProgramServicesAmt |
| Management And General | $15,816 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PATIENT SUPPLIES | $365,410 | $365,410 |
| BAD DEBT EXPENSE | $183,789 | $183,789 |
| PUBLICATIONS AND SUBSCR | $27,039 | $27,039 |
| RECRUITMENT | $5,130 | $5,130 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,065,843 | TotalAmt |
| Program Services | $5,452,009 | ProgramServicesAmt |
| Management And General | $1,613,834 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,197 | BOYAmt |
| EOY | $555,490 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,222,793 | BOYAmt |
| EOY | $4,185,649 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,024 | BOYAmt |
| EOY | $153,630 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,182,478 | BOYAmt |
| EOY | $600,172 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,169 | BOYAmt |
| EOY | $26,441 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,218 | BOYAmt |
| EOY | $28,220 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,307,453 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,908,140 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,678,237 | BOYAmt |
| EOY | $3,399,313 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,300,116 | BOYAmt |
| EOY | $8,948,915 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $678,437 | BOYAmt |
| EOY | $698,079 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,281,037 | BOYAmt |
| EOY | $2,186,739 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $887,900 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,414,147 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,959,474 | BOYAmt |
| EOY | $5,186,865 | 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 | $4,340,642 | BOYAmt |
| EOY | $3,604,290 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $157,760 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,340,642 | BOYAmt |
| EOY | $3,762,050 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,300,116 | BOYAmt |
| EOY | $8,948,915 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$578,592 | 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 | $75,000 | OtherCostOrOtherBasisAmt |
| Book Value | $75,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,060,960 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,228,452 | DepreciationAmt |
| Book Value | $2,832,508 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,697,369 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,545,393 | DepreciationAmt |
| Book Value | $151,976 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $474,124 | OtherCostOrOtherBasisAmt |
| Depreciation | $134,295 | DepreciationAmt |
| Book Value | $339,829 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,399,313 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | REFUNDABLE ADVANCE | Desc |
| Amt | $1,414,147 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,414,147 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $6,487,251 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,487,251 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,487,251 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,065,843 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $7,065,843 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $7,065,843 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARI FREIBERG | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $165,930 | $0 | $0 | $0 | $0 | $0 | $6,843 | $0 | $10,856 | $0 | $183,629 | $0 | $0 | $0 |
| ELIZABETH BADE | ||||||||||||||
| MEDICAL DIRECTOR | $207,071 | $0 | $1,730 | $0 | $0 | $0 | $8,739 | $0 | $9,500 | $0 | $227,040 | $0 | $0 | $0 |
| JAMES SUEPPEL | ||||||||||||||
| DENTIST | $190,913 | $0 | $453 | $0 | $0 | $0 | $7,896 | $0 | $9,500 | $0 | $208,762 | $0 | $0 | $0 |
| BRENT PARKER | ||||||||||||||
| DENTIST | $156,531 | $0 | $489 | $0 | $0 | $0 | $6,368 | $0 | $3,540 | $0 | $166,928 | $0 | $0 | $0 |
| MARK HEBERLEIN | ||||||||||||||
| PHYSICIAN | $213,917 | $0 | $566 | $0 | $0 | $0 | $4,040 | $0 | $7,375 | $0 | $225,898 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE PREPARED FORM 990 IS REVIEWED BY THE GOVERNING BODY AND MANAGEMENT BEFORE THE RETURN IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY ALL DIRECTORS AND EMPLOYEES COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT. THE SIGNED STATEMENTS ARE REVIEWED AND MAINTAINED BY THE CHIEF EXECUTIVE OFFICER. A COMPREHENSIVE LEGAL REVIEW OF THE CONFLICT OF INTEREST POLICY IS CONDUCTED EVERY THREE YEARS, WITH THE LATEST REVIEW COMPLETED IN 2017. LEGAL COUNSEL IS CONSULTED IN THE INTERIM YEARS IF THERE ARE ADDITIONAL MATTERS IDENTIFIED THAT MAY REPRESENT A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE DIRECTORS ANNUALLY CONDUCT A PERFORMANCE REVIEW OF THE CHIEF EXECUTIVE OFFICER. HUMAN RESOURCES COLLECTS COMPENSATION INFORMATION FROM OUTSIDE SOURCES AND PRESENTS THIS INFORMATION TO THE DIRECTORS FOR THEIR CONSIDERATION WHEN DETERMINING THE CHIEF EXECUTIVE OFFICER'S COMPENSATION. THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS APPROVED BY THE DIRECTORS AND DELIBERATIONS AND DECISIONS ABOUT THE CHIEF EXECUTIVE OFFICER'S COMPENSATION ARE DOCUMENTED IN THE MINUTES OF THE MEETINGS OF THE GOVERNING BODY. AN ANNUAL PERFORMANCE REVIEW IS ALSO CONDUCTED FOR KEY EMPLOYEES TO IDENTIFY THE PERCENTAGE BY WHICH THE KEY EMPLOYEES' SALARY SHOULD BE ADJUSTED. CONTRACTED KEY EMPLOYEES ALSO HAVE OPPORTUNITIES TO NEGOTIATE WAGES AT CONTRACT TIME. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |