2020-01-15T09:07:50-06:00 2019-02-28 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-03-01 421527584 COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC % RONALD KEMP COMM 3197532300 1706 W AGENCY ROAD WEST BURLINGTON IA 52655 RONALD KEMP CEO 2019-07-11 true Krystal K Creach P01248198 4178658701 167.68.126.162 43032920200155000012 2020-01-15 P 74C51B083D6172D3D43AC87F1A33B4712A418457 EADA8263F67F30EEC173F90D1C5FD4FB3EC213FF 2018 2020-09-22 18:59:49Z RONALD KEMP 1706 W AGENCY ROAD WEST BURLINGTON IA 52655 17450805 false X CHCSEIA.COM X 2001 IA CHCSEIA PROVIDES COMPREHENSIVE HEALTH SERVICES, GENERAL DENTISTRY AND COMMUNITY HEALTH PROGRAMS, AND OTHER HEALTH CARE SERVICES TO RESIDENTS OF THE SE IOWA REGION. 9 9 152 10 0 3916957 3213276 12150675 14166635 4053 5069 39325 65825 16111010 17450805 0 0 0 0 8934476 10567193 0 0 0 5562574 5684261 14497050 16251454 1613960 1199351 11487923 13198193 3243908 3754827 8244015 9443366 X TO PROVIDE PRIMARY HEALTH CARE TO RESIDENTS OF THE GREATER SE IOWA REGION, ESPECIALLY THOSE INDIVIDUALS/FAMILIES WITH LIMITED RESOURCES OR WITH OTHER BARRIERS TO HEALTH CARE. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. false false 12082758 14166635 COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA PROVIDES SEVERAL HEALTH SERVICES TO THE COMMUNITY, INCLUDING: COMPREHENSIVE HEALTH SERVICES WITH A VARIETY OF PHYSICIAN SPECIALTIES, GENERAL DENTISTRY AND COMMUNITY HEALTH PROGRAMS INVOLVING ORAL HEALTH EDUCATION AND DENTAL SCREENING, FAMILY PLANNING, HEALTH SCREENINGS, IMMUNIZATIONS, CASE MANAGEMENT, AND PHARMACIES. DURING THE FISCAL YEAR, THE HEALTH CENTERS HAD APPROXIMATELY 19,800 DENTAL VISITS AND 40,600 MEDICAL VISITS. 12082758 true true false true false false false false false false true false false true true false true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false true 33 0 true 152 true false false false false false false false false false false false false X 9 9 false false false false false false false true true false false true true true true true true true true false X RONALD KEMP 3197532300 1706 WEST AGENCY ROAD WEST BURLINGTON IA 52655 BARB BAKER DIRECTOR 1.0 0.0 X 0 0 0 BARRY CORSON CHAIR END 12/18, VICE CHAIR 1.0 0.0 X X 0 0 0 JASON STRANDBERG VICE CHAIR ENDED 12/18, CHAIR 1.0 0.0 X X 0 0 0 BILL STAATS SECRETARY 1.0 0.0 X X 0 0 0 MIKE MAUZY TREASURER 1.0 0.0 X X 0 0 0 CHUCK GRIFFIN DIRECTOR 1.0 0.0 X 0 0 0 DENISE OSBORN DIRECTOR 1.0 0.0 X 0 0 0 JULIE SCHILLING DIRECTOR 1.0 0.0 X 0 0 0 KATHY VANCE DIRECTOR, END 1/19 1.0 0.0 X 0 0 0 DAVID WHITAKER DIRECTOR 1.0 0.0 X 0 0 0 RONALD KEMP CEO 40.0 0.0 X 128591 0 20416 DIANE ROUSE CFO 40.0 0.0 X 90995 0 29608 JOHN BRADY CMO 30.0 0.0 X 240992 0 0 LUCAS LEMBURG CHIEF DENTAL OFFICER 40.0 0.0 X 187033 0 34264 MARK STROPE PHYSICIAN 40.0 0.0 X 209999 0 22574 ALAN ALEXANDER PEDIATRICIAN 37.0 0.0 X 229463 0 36792 TESSA JOHNSON DENTISTS 40.0 0.0 X 171706 0 33331 ALISHA BASSLER DENTIST 40.0 0.0 X 143719 0 31741 JAMES DEMMEL PHYSICIAN 40.0 0.0 X 257831 0 39519 1660329 0 248245 8 false true false QUEST DIAGNOSTICS PO BOX 775460 CHICAGO IL 606775460 HEALTH SERVICES 217794 PAIN CENTERS OF IOWA 5515 UTICA RIDGE ROAD 600 DAVENPORT IA 52807 HEALTH SERVICES 280170 STAFF CARE INC PO BOX 281923 ATLANTA GA 303841923 HEALTH SERVICES 162367 GREAT RIVER JANITORIAL 606 BROADWAY WEST BURLINGTON IA 52655 JANITORIAL SERVICES 108790 4 3034929 178347 3213276 NET PATIENT SERVICE REVENUE 624100 14098991 14098991 MEANINGFUL USE REVENUE 624100 59500 59500 OTHER REVENUE 624100 8144 8144 14166635 5069 5069 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 GAIN ON INV IN EQUITY INVESTEE 900099 65825 65825 65825 17450805 14166635 70894 X 0 0 0 0 731899 462289 269610 0 7551745 5466991 2084754 295230 197525 97705 1428828 952805 476023 559491 366506 192985 0 12448 12448 101275 101275 0 0 0 2085385 1606694 478691 6309 5012 1297 368182 292860 75322 0 0 496048 407855 88193 46462 37604 8858 0 49320 39181 10139 101299 65474 35825 0 505607 336759 168848 87495 69508 17987 BAD DEBT 467257 467257 MEDICAL SUPPLIES & DRUGS 1120108 1120108 LICENSES, DUES, SUBSCRIPTIONS 98827 78510 20317 RECRUITING & RETENTION 138239 109820 28419 16251454 12082758 4168696 0 203297 164582 688021 968360 256412 3930 1301319 1266212 0 0 0 0 0 0 232679 181877 182833 52179 11282751 3848610 7066406 7434141 0 0 0 0 59547 125372 0 0 1497409 3001540 11487923 13198193 1407817 951997 0 0 209183 43000 0 0 0 0 0 0 1201589 2272994 0 0 425319 486836 3243908 3754827 X 7994270 9443366 249745 0 0 0 8244015 9443366 11487923 13198193 1199351 X false true X true true true X 2793614 2187729 2708922 3916957 3213276 14820498 0 0 2793614 2187729 2708922 3916957 3213276 14820498 0 14820498 3414 2501 4600 4053 5069 19637 0 0 14840135 54872101 0.99868 0.99876 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC), THE IOWA PRIMARY CARE ASSOCIATION (IAPCA), AND THE ILLINOIS PRIMARY HEALTHCARE ASSOCIATION (ILPHCA). A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES. 223943 223943 8204113 1780768 6423345 247361 230877 16484 1947371 1293957 653414 659963 543008 116955 7434141 DUE FROM THIRD PARTY PAYERS 2363300 OTHER RECEIVABLES 151404 457(B) ASSETS 486836 3001540 0 DEFERRED COMPENSATION 486836 486836 16774366 -467257 -467257 17241623 209182 209182 17450805 15784197 15784197 467257 467257 16251454 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VII, LINE 12: $ (467,257) BAD DEBT EXPENSE SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 209,182 GRANTS FOR ACQUISITION OF EQUIPMENT SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 467,257 BAD DEBT EXPENSE X true true X X false false false false false false false true false MARK STROPE PHYSICIAN 192088 0 17911 0 0 0 10591 0 11983 0 232573 0 ALAN ALEXANDER PEDIATRICIAN 207968 0 21495 0 0 0 11706 0 25086 0 266255 0 TESSA JOHNSON DENTISTS 150406 0 21300 0 0 0 8616 0 24715 0 205037 0 ALISHA BASSLER DENTIST 118559 0 25160 0 0 0 7409 0 24332 0 175460 0 JAMES DEMMEL PHYSICIAN 225497 0 32334 0 0 0 13185 0 26334 0 297350 0 JOHN BRADY CMO 240992 0 0 0 0 0 0 0 0 0 240992 0 LUCAS LEMBURG CHIEF DENTAL OFFICER 155102 0 29039 0 2892 0 9580 0 24684 0 221297 0 SCHEDULE J, PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES: THE ORGANIZATION OFFERS A WELLNESS PROGRAM TO ITS EMPLOYEES WHICH PROVIDES DIRECT REIMBURSEMENT OF UP TO $25 PER MONTH AFTER THE EMPLOYEES HAVE USED THE GYM OR WEIGHT WATCHERS PROGRAM THREE TIMES DURING THE MONTH. EMPLOYEE MUST SHOW DOCUMENTATION OF PAYMENT OF FEES AND ATTENDANCE. IF ATTENDANCE IS LESS THAN THREE TIMES A MONTH, NO PAYMENT IS MADE. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: BONUS AMOUNTS PAID ARE BASED ON PRODUCTION LEVELS. FORM 990, PART I, LINE 6 VOLUNTEERS: THE ORGANIZATION'S BOARD OF DIRECTORS IS A VOLUNTEER BOARD. FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION: CHCSEIA IS A FEDERALLY QUALIFIED HEALTH CENTER WHOSE MISSION IS TO PROVIDE AFFORDABLE, COMPREHENSIVE, CULTURALLY APPROPRIATE, COST EFFECTIVE HEALTH CARE TO RESIDENTS OF THE GREATER SOUTHEASTERN IOWA REGION IN ORDER TO IMPROVE THEIR OVERALL HEALTH STATUS. THE MAIN PURPOSES OF THE ORGANIZATION ARE THE FOLLOWING: -PROVIDE PRIMARY MEDICAL CARE, GENERAL DENTAL SERVICES, AND INTEGRATED BEHAVIORAL HEALTH SERVICES -CREATE NEW HEALTH CARE RESOURCES AND HEALTH CARE ARRANGEMENTS TO OFFER TO THE COMMUNITIES SERVED BY THE CORPORATION -EXPAND ACCESS TO HEALTH CARE TO THOSE INDIVIDUALS UNABLE TO OBTAIN ADEQUATE HEALTH CARE -REDUCE UNNECESSARY DUPLICATION OF SERVICES, TECHNOLOGY AND FACILITIES BY COORDINATING THE DELIVERY OF HEALTH CARE SERVICES ON A COST-EFFECTIVE BASIS -CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED OR THE PROMOTION OR HEALTH WHICH MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS OR OTHER REQUIREMENTS THAT ARE OR CAN BE MADE AVAILABLE -PROMOTE AND CARRY ON SPECIAL RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED INSOFAR AS SAID RESEARCH CAN BE CARRIED ON, OR IN CONNECTION WITH, THE FACILITIES AND PROGRAMS OPERATED BY THIS CORPORATION -TAKE AND HOLD BY BEQUEST, DEVISE, GIFT, GRANT, PURCHASE, LEASE OR OTHERWISE ANY PROPERTY, REAL, PERSONAL, TANGIBLE OR INTANGIBLE, OR ANY UNDIVIDED INTEREST THEREIN, WITHOUT LIMITATION AS TO AMOUNT OR VALUE -SELL, CONVEY OR TO OTHER DISPOSE OF ANY SAID PROPERTY AND INVEST, REINVEST, OR DEAL WITH THE PRINCIPAL OR THE INCOME THEREOF IN SAID MANNER AS, IN THE JUDGEMENT OF THE DIRECTORS OF THIS CORPORATION, WILL BEST PROMOTE THE PURPOSES OF THE CORPORATION WITHOUT LIMITATION, EXCEPT SUCH LIMITATIONS, IF ANY AS MAY BE CONTAINED IN THE INCORPORATION, THE BYLAWS OF THE CORPORATION, OR ANY OTHER LAWS THERETO APPLICABLE. -RAISE GIFTS, BEQUESTS, DONATIONS, AND OTHER FUNDS FROM THE PUBLIC AND FROM ALL OTHER SOURCES AVAILABLE, RECEIVE AND MAINTAIN SUCH FUNDS AND EXPEND PRINCIPAL AND INCOME THERE FROM IN SUPPORT OF OR IN FURTHERANCE OF THE CHARITABLE PURPOSES OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO BEING FILED, THE RETURN IS REVIEWED BY THE ORGANIZATION'S CEO AND CFO. IT IS THEN PROVIDED TO THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: A. GENERAL PRINCIPLES PROHIBITING CONFLICTS: NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR MEMBER OF THE BOARD OF DIRECTORS OF CHC/SEIA WILL PARTICIPATE IN THE SELECTION, AWARD, OR ADMINISTRATION OF A CONTRACT OR GRANT (SUPPORTED BY FEDERAL FUNDS) IF A REAL OR APPARENT CONFLICT OF INTEREST WOULD BE INVOLVED. SUCH A CONFLICT WOULD ARISE WHEN THE EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR BOARD MEMBER, OR ANY MEMBER OF HIS OR HER IMMEDIATE FAMILY, HIS OR HER PARTNER, OR AN ORGANIZATION WHICH EMPLOYS OR IS ABOUT TO EMPLOY ANY OF THE PARTIES INDICATED HEREIN, HAS A FINANCIAL OR OTHER INTEREST IN THE FIRM SELECTED FOR THE CONTRACT OR AWARD. B. CONFLICTS OF INTEREST AND DISCLOSURE REQUIREMENTS: NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR BOARD MEMBER WILL HAVE A DIRECT OR INDIRECT FINANCIAL INTEREST IN, OR RECEIVE ANY COMPENSATION OR OTHER BENEFITS AS A RESULT OF, TRANSACTIONS BETWEEN CHC/SEIA AND ANY INDIVIDUAL OR BUSINESS FIRM WITHOUT DISCLOSING THE CONFLICT OF INTEREST. NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER, OR MEMBER OF THE BOARD OF DIRECTORS MAY PARTICIPATE IN THE SELECTION, AWARD, OR ADMINISTRATION OF A CONTRACT OR GRANT IN WHICH FEDERAL FUNDS ARE USED, IF THEY HAVE A FINANCIAL OR OTHER INTEREST IN THE FIRM SELECTED FOR THE CONTRACT OR AWARD WITHOUT DISCLOSING THE CONFLICT OF INTEREST. IF AN EMPLOYEE, CONTRACTOR, AGENT, OFFICER, OR MEMBER OF THE BOARD OF DIRECTORS BELIEVES THAT ONE OF THE AFOREMENTIONED CONFLICTS ACTUALLY OR POTENTIALLY EXISTS, HE OR SHE MUST IMMEDIATELY DISCLOSE THIS INFORMATION IN WRITING TO THE CEO. DISCLOSURES BY MEMBERS OF THE BOARD OF DIRECTORS MUST ALSO BE MADE TO THE CHAIR OF THE BOARD OF DIRECTORS (AND IF IT IS THE CEO OR THE CHAIR WHO HAS SUCH A FINANCIAL INTEREST, HE OR SHE MUST MAKE DISCLOSURE TO THE CHAIR OR VICE CHAIR, RESPECTIVELY). THE CHC/SEIA REQUIRES THAT ALL EMPLOYEES, CONTRACTORS, AGENTS, OFFICERS AND MEMBERS OF THE BOARD OF DIRECTORS AND CANDIDATES FOR BOARD MEMBERSHIP DISCLOSE IN WRITING (AND UPDATE AT LEAST ANNUALLY) AT OR AROUND THEIR JANUARY MEETING: - ALL BUSINESS AND FAMILY RELATIONSHIPS WHICH CREATE AN ACTUAL OR POTENTIAL A CONFLICT OF INTEREST, AND - WHERE APPLICABLE, PROVIDE A STATEMENT SUGGESTING HOW SUCH CONFLICT COULD BE AVOIDED OR MITIGATED. TO FACILITATE DISCLOSURE, CHC/SEIA REQUIRES EMPLOYEES, CONTRACTORS, AGENTS) OFFICERS AND BOARD MEMBERS TO COMPLETE A CHC/SEIA CONFLICT OF INTEREST FORM. COMPLETION THE FORM DOES NOT RELIEVE INDIVIDUALS OF THE OBLIGATION TO NOTIFY THE CEO OR BOARD CHAIR IF CHANGES OCCUR SINCE FILING OF THE FORM REGARDING A NEW CONFLICT OF INTEREST. NO MEMBER OF THE BOARD OF DIRECTORS MAY VOTE ON ANY MATTER WHICH MAY DIRECTLY OR INDIRECTLY RESULT IN FINANCIAL OR OTHER GAIN TO THAT MEMBER, OR WHICH MAY CONFLICT WITH THAT MEMBER'S OBLIGATIONS TO ANOTHER ORGANIZATION'S BOARD OF DIRECTORS OR TO HIS OR HER EMPLOYER. PROVIDED THAT THE MEMBER OF THE BOARD OF DIRECTORS HAS FIRST DISCLOSED A CONFLICT OR POTENTIAL CONFLICT, AND ABSTAINS FROM VOTING IN THAT REGARD, HE OR SHE MAY PARTICIPATE IN DISCUSSIONS RELATING TO THAT MATTER. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION REVIEW: DURING FISCAL YEAR 2019, THE CEO, CFO, AND BOARD APPROVED RATES USING SALARY SURVEYS FOR COMPARABLE POSITIONS FORM THE IAPCA, ILPHCA, NACHC, IOWA WORKFORCE AND OTHER SOURCES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC EXCEPT IN CASES WHERE IT IS REQUIRED BY LAW. FINANCIAL STATEMENTS ARE ONLY RELEASED FOR ACTIVITIES THAT ARE DEEMED NECESSARY FOR BONA FIDE BUSINESS PURPOSES, SUCH AS LOANS, OR IN CASES WHERE IT IS REQUIRED BY LAW. FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:754115 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:505587 FORM 990 PART IX LINE 11G DESCRIPTION:HIT EXPENSE TOTAL FEES:342476 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:218301 FORM 990 PART IX LINE 11G DESCRIPTION:LABORATORY TOTAL FEES:173012 FORM 990 PART IX LINE 11G DESCRIPTION:INTERPRETER SERVICES TOTAL FEES:39824 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING SUBMISSION EXPENSE TOTAL FEES:28011 FORM 990 PART IX LINE 11G DESCRIPTION:PAYROLL SERVICES TOTAL FEES:24059