2025-10-17T09:51:41+00:00 2025-01-31 440160260 Forvis Mazars LLP 910 E St Louis 200 PO Box 1190 Springfield MO 658062523 990 2024-02-01 421374894 Siouxland Community Health Center SIOU 7122522477 1021 NEBRASKA ST SIOUX CITY IA 51105 JAN ANDERSON CHIEF FINANCIAL OFFICER 7122522477 2025-10-17 true Krystal Creach P01248198 4178658701 2025-10-17 2024 2025-03-06 01:10:19Z MARK DONALDSON 1021 NEBRASKA ST SIOUX CITY IA 51105 48176842 false X WWW.SLANDCHC.COM X 1991 IA TO BE A PATIENT-CENTERED MEDICAL HOME WHICH IMPROVES THE PHYSICAL, DENTAL, AND BEHAVIORAL HEALTH OF THE SIOUXLAND COMMUNITY WHILE ELIMINATING ACCESS BARRIERS. 14 14 406 17 0 12391747 6853493 41008827 40153322 952122 1125977 66360 44050 54419056 48176842 258118 249658 0 28206028 29958974 0 0 0 17388734 20629775 45852880 50838407 8566176 -2661565 56997169 54290162 5816785 5755789 51180384 48534373 INSPIRING AND EMPOWERING OUR COMMUNITY THROUGH HEALTH EQUITY FOR ALL. false false 26190140 249658 22112527 PRIMARY AND SPECIALTY MEDICAL SERVICES FOR FYE 2025: SCHC PROVIDED MEDICAL, PRENATAL, AND BEHAVIORAL HEALTH SERVICES FOR 98,791 PATIENT VISITS. SERVICES WERE PROVIDED BY FIVE PRIMARY CARE PHYSICIANS, EIGHT PHYSICIAN ASSISTANTS, AND TWENTY NURSE PRACTITIONERS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 8533256 0 12856768 PHARMACY: THE SCHC PHARMACY IS AVAILABLE TO ALL PATIENTS RECEIVING HEALTH CARE SERVICES AT THE HEALTH CENTER. SEVEN PHARMACISTS ARE ON STAFF TO OFFER MEDICATION COUNSELING FOR PRESCRIPTIONS. IN ADDITION, THE HEALTH CENTER EMPLOYED TWO FULL-TIME CLINICAL PHARMACIST TO ASSIST PATIENTS WITH CHRONIC MEDICAL CONDITIONS. SCHC IS A PARTICIPANT IN THE 340B DRUG PRICING PROGRAM AND ALSO OFFERS AN INDIGENT PROGRAM TO PROVIDE PRESCRIPTION ASSISTANCE TO QUALIFYING PATIENTS. THE SCHC PHARMACY ALSO PARTICIPATES IN OTHER PHARMACEUTICAL ASSISTANCE PROGRAMS TO ENSURE PATIENTS HAVE ACCESS TO NEEDED PRESCRIPTION DRUGS. 3848523 0 5184027 DENTAL CARE FOR FYE 2025: SCHC EMPLOYED SEVEN DENTISTS AND SEVEN DENTAL HYGIENISTS TO PROVIDE ROUTINE DENTAL CARE AND TREATMENT TO PATIENTS AGED INFANTS TO ADULTS. EMERGENCY WALK-IN PATIENTS ARE ACCEPTED DAILY. THE DENTAL DEPARTMENT HAD 17,495 PATIENT VISITS DURING THE YEAR ENDING 1/31/25. 38571919 true true false true false false false false false false true false false false true false true false false false false false false false false false false false true true true false false false false false false false false false false true false false false false false false false false false true 103 0 true 406 true false false false false false false false false false false false false X 14 14 false false false false false false false true true false false false true true true true true true true false false false X TALIA PETERSON 7122522477 1021 NEBRASKA STREET SIOUX CITY IA 51105 DAVID OLSON BOARD TREASURER END 02/24; MEMBER AT LARGE END 07/24 1.0 0.0 X X 0 0 0 DR DONA PRINCE BOARD CHAIR 1.0 0.0 X X 0 0 0 JENNIFER JACKSON SECRETARY BEG 03/24 1.0 0.0 X X 0 0 0 NEIL BARTHOLOMEW BOARD TREASURER BEG 03/24 1.0 0.0 X X 0 0 0 TREYLA LEE SECRETARY END 02/24; BOARD VICE CHAIR BEG 03/24 1.0 0.0 X X 0 0 0 ABDULLAHI URUR MEMBER AT LARGE 1.0 0.0 X 0 0 0 DORA JUNG MEMBER AT LARGE END 12/24 1.0 0.0 X 0 0 0 DR KEITH VOLLSTEDT MEMBER AT LARGE 1.0 0.0 X 0 0 0 JANE ARNOLD MEMBER AT LARGE END 02/24 1.0 0.0 X 0 0 0 JAY ROSENBERG MEMBER AT LARGE 1.0 0.0 X 0 0 0 JENNIFER BRAVANTE-BURKHART MEMBER AT LARGE 1.0 0.0 X 0 0 0 LAWRENCE JENSEN MEMBER AT LARGE 1.0 0.0 X 0 0 0 LYDIA JESSIP MEMBER AT LARGE BEG 09/24 1.0 0.0 X 0 0 0 MONA ZUFFANTE MEMBER AT LARGE 1.0 0.0 X 0 0 0 REVATHI TRUONG MEMBER AT LARGE 1.0 0.0 X 0 0 0 WENDY LINDLEY MEMBER AT LARGE BEG 03/24 1.0 0.0 X 0 0 0 WILLIE SUAREZ MEMBER AT LARGE 1.0 0.0 X 0 0 0 ANDREA BUCKLEY INTERIM CEO BEG 04/24, END 11/24 40.0 0.0 X 134282 0 451 DR MICHAEL PIPLANI CHIEF MEDICAL OFFICER 40.0 0.0 X 346336 0 54034 JAN ANDERSON CHIEF FINANCIAL OFFICER 40.0 0.0 X 176786 0 62190 MARI KAPTAIN-DAHLEN CHIEF EXECUTIVE OFFICER END 04/24 40.0 0.0 X 126460 0 23384 MARK DONALDSON CEO BEG 11/24 40.0 0.0 X 53284 0 1591 DAVID FALDMO QUALITY DIRECTOR 40.0 0.0 X 309727 0 83692 DR ASHLEY HUBER DENTAL DIRECTOR 40.0 0.0 X 251185 0 57135 DR DYLAN GREENE PHYSICIAN 40.0 0.0 X 273901 0 59726 DR KELLY RYDER PHYSICIAN 40.0 0.0 X 279210 0 33906 DR KRISTI WALZ PHYSICIAN 40.0 0.0 X 324173 0 80098 DR THOMAS MORGAN PHYSICIAN 40.0 0.0 X 283452 0 78903 DR TYLER WENDEL PHYSICIAN 40.0 0.0 X 309330 0 66900 2868126 0 602010 57 false true false INCONCERTCARE INC 500 SW 7TH STREET DES MOINES IA 50309 SOFTWARE SUPPORT 1593374 SIOUXLAND OBGYN 2730 PIERCE STREET SIOUX CITY IA 51104 OBSTETRICAL SERVICES 979292 H & R CONSTRUCTION 307 E 39TH ST SOUTH SIOUX CITY NE 687763550 CONSTRUCTION 621166 VISUALTIONS INC 7440 MINTWOOD LN SPRING TX 773791100 OUTSOURCED CODING 417907 FORVIS MAZARS LLP 910 E ST LOUIS ST SPRINGFIELD MO 65810 AUDIT/TAX/CONSULTING 337650 11 6644958 208535 1287208 6853493 NET PATIENT SERVICE REVENUE 624100 40024062 40024062 OTHER REVENUE 624100 129260 129260 0 0 0 0 40153322 1125977 1125977 0 0 0 0 0 GAIN ON EQUITY INVESTEE 900099 44050 44050 0 0 0 0 44050 48176842 40153322 0 1170027 249658 249658 1680537 1102109 578428 23297418 18976732 4320686 811845 670167 141678 2496621 2016733 479888 1672553 1342237 330316 26184 26184 131308 131308 4670935 2126578 2544357 0 139505 55592 83913 512858 204975 307883 301144 120005 181139 306150 122000 184150 41494 35705 5789 576951 243063 333888 102121 102121 2095838 345813 1750025 247095 98467 148628 MEDICAL SUPPLIES & DRUGS 10453910 10453910 REPAIRS & MAINTENANCE 426459 169943 256516 RECRUITING & RETENTION 420907 167731 253176 LICENSES, DUES, SUBSCRIPTIONS 176916 70501 106415 0 0 0 0 50838407 38571919 12266488 0 330241 12180 26055726 25084268 250460 98245 7744037 6416623 0 0 0 0 506169 660715 430416 697812 31606348 13689261 18741281 17917087 754815 798865 0 1651796 1507306 532228 1097061 56997169 54290162 3303033 3420867 1947225 1463527 0 0 566527 871395 5816785 5755789 X 51027422 48351022 152962 183351 51180384 48534373 56997169 54290162 -2661565 15554 0 X false true true true true X 6713145 13312942 12399042 12391747 6853493 51670369 0 0 6713145 13312942 12399042 12391747 6853493 51670369 0 51670369 134708 81390 450344 1061959 1125977 2854378 0 0 0 0 0 0 0 54524747 175232332 0.94765 0.96090 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 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE ORGANIZATION PAID DUES OF $25,000 TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND $59,852.64 TO THE IOWA PRIMARY CARE ASSOCIATION. A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES. 1715667 1715667 22441114 9358723 13082391 7417486 4330538 3086948 32081 32081 17917087 Federal Income Taxes INTEREST RATE SWAP 17383 DEFERRED COMP LIABILITY 522567 EST DUE TO THIRD PARTIES 215705 LEASE LIABILITY 115740 871395 48162557 15554 550 152962 169066 47993491 183351 183351 48176842 50838957 550 0 550 50838407 0 0 50838407 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 2(d) Other revenues in audited financial statements not in form 990 NET ASSETS RELEASED FROM RESTRICTIONS - 152962 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements TEMPORARILY RESTRICTED CONTRIBUTIONS - 183351 true RENT ASSISTANCE 24 136384 UTILITIES ASSISTANCE 66 74286 CO-PAY ASSISTANCE 59 28769 PATIENT FOOD ASSISTANCE 84 10159 VISION ASSISTANCE 1 60 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds PATIENTS WITHIN THE HIV PROGRAM MAY QUALIFY FOR THE FOLLOWING PROGRAMS: RENTAL ASSISTANCE, MEDICAL/DENTAL/VISION CO-PAY ASSISTANCE, FOOD ASSISTANCE, AND UTILITIES ASSISTANCE. INDIVIDUALS MUST DEMONSTRATE A NEED FOR FINANCIAL ASSISTANCE AND THEY MUST FOLLOW-UP REGULARLY WITH THE STAFF AT THE CLINIC. X X X X false false false false false false false true false JAN ANDERSON CHIEF FINANCIAL OFFICER 169023 0 1600 0 6163 0 30500 0 31690 0 238976 0 0 0 DR MICHAEL PIPLANI CHIEF MEDICAL OFFICER 333463 0 8500 0 4373 0 28820 0 25214 0 400370 0 0 0 DR ASHLEY HUBER DENTAL DIRECTOR 240839 0 4250 0 6096 0 13016 0 44119 0 308320 0 0 0 DAVID FALDMO QUALITY DIRECTOR 267177 0 16920 0 25630 0 30500 0 53192 0 393419 0 0 0 DR DYLAN GREENE PHYSICIAN 260077 0 4760 0 9064 0 23000 0 36726 0 333627 0 0 0 DR KELLY RYDER PHYSICIAN 277610 0 1600 0 0 0 14711 0 19195 0 313116 0 0 0 DR KRISTI WALZ PHYSICIAN 297158 0 11360 0 15655 0 28170 0 51928 0 404271 0 0 0 DR THOMAS MORGAN PHYSICIAN 281852 0 1600 0 0 0 30500 0 48403 0 362355 0 0 0 DR TYLER WENDEL PHYSICIAN 289856 0 5437 0 14037 0 19649 0 47251 0 376230 0 0 0 Schedule J, Part I, Line 7 Non-fixed payments MONTHLY INCENTIVE PAYMENTS BASED ON PRODUCTION ARE PAID TO EMPLOYEES SUBJECT TO THE DISCRETION OF THE BOARD OF DIRECTORS. A WOODBURY COUNTY IOWA 426005221 000000000 2007-09-25 7000000 CONSTRUCT NEW FACILITY false false false A 5522940 0 7000000 0 0 0 100000 0 6900000 0 0 0 2009 false false true true A false false false false false false 0.0 0.0 0.0 true false 0 false true A false false false true true true WELLS FARGO 20.0 false false false 0 false false false A true Schedule K, Part IV, Line 2c COLUMN A Issuer name: WOODBURY COUNTY, IOWA The calculation for computing no rebate due was performed on 11/07/2022 1 1287208 Market value 0 false true false Schedule M, Part I Explanations of reporting method for number of contributions Drugs and medical supplies - THE NUMBERS ENTERED IN COLUMN B REPRESENT THE NUMBER OF DONORS WHO CONTRIBUTED THESE ITEMS DURING THE YEAR. Form 990, Part III, Line 4 PROGRAM SERVICES SIOUXLAND COMMUNITY HEALTH CENTER (SCHC) IS DEDICATED TO MEETING THE HEALTHCARE NEEDS OF THE SIOUXLAND AREA AND IS A LEVEL THREE PATIENT CENTERED MEDICAL HOME. SCHC OFFERS THE FOLLOWING SERVICES: PRIMARY AND SPECIALTY MEDICAL SERVICES, FAMILY PLANNING SERVICES PRENATAL SERVICES, LABORATORY, RADIOLOGY, HIV/AIDS AND HEPATITIS CARE, BEHAVIORAL HEALTH, PHARMACY, AND DENTAL SERVICES. SCHC PROVIDES FINANCIAL ASSISTANCE TO THE UNINSURED AND UNDERINSURED TO ELIMINATE ACCESS BARRIERS. Form 990, Part III, Line 4a PROGRAM SERVICE ACTIVITY #1 LABORATORY SIOUXLAND COMMUNITY HEALTH CENTER LABORATORY CURRENTLY CONDUCTS APPROXIMATELY 96% OF ITS LABORATORY TESTS ONSITE AND IS A MODERATE COMPLEX LABORATORY. FOR THOSE TESTS NOT PERFORMED ONSITE, THEY ARE SENT TO A REFERENCE LABORATORY WHERE THE MAJORITY OF TEST RESULTS ARE RETURNED WITHIN 24-72 HOURS. CONDUCTING THE MAJORITY OF TESTS ONSITE ENSURES RAPID TURNAROUND FOR DIAGNOSIS AND MONITORING OF CHRONIC MEDICAL CONDITIONS. THE LABORATORY WAS ACCREDITED BY CLIA THROUGH THE YEAR ENDING 9/23/27, THE LABORATORY PERFORMED 505,079 TESTS. RADIOLOGY SCHC CONDUCTS RADIOLOGY SERVICES. IT PERFORMED 5,057 EXAMS FOR THE YEAR ENDING 1/31/25. SCHC ALSO PROVIDES ULTRASOUND SERVICES AND PERFORMED 3,291 EXAMS FOR THE YEAR ENDING 1/31/25. HIV/AIDS AND HEPATITIS THE HIV TEAM SERVES THE TRI-STATE SIOUXLAND AREA, AS WELL AS 24 ADDITIONAL IOWA COUNTIES, 4 COUNTIES IN NEBRASKA, AND 5 COUNTIES IN SOUTH DAKOTA. APPROXIMATELY 21% OF PATIENTS RECEIVING HIV/AIDS CARE LIVE IN RURAL AREAS. IN ADDITION TO MEDICAL CARE, THE HIV TEAM COORDINATES DENTAL CARE, CASE MANAGEMENT, TRANSPORTATION, AND HOUSING ASSISTANCE. FOR THE FISCAL YEAR ENDING 1/31/25, THE HIV TEAM SERVED 255 PATIENTS. FINANCIAL SERVICES TO ENSURE PATIENTS HAVE ACCESS TO CARE AT AN AFFORDABLE RATE, SCHC OFFERS A SLIDING FEE DISCOUNT TO PATIENTS BASED ON INCOME ELIGIBILITY AND ACCEPTS MEDICAID (TITLE 19), MEDICARE (TITLE 18), HAWK-I (STATE CHIP) AND MOST PRIVATE INSURANCES. FOR FISCAL YEAR ENDING 1/31/25, 14% OF PATIENTS RECEIVING CARE WERE UNINSURED, 47% HAD COVERAGE BY MEDICAID/HAWK-I, 11% HAD MEDICARE COVERAGE, AND 29% HAD COVERAGE BY OTHER SOURCES. SCHC EMPLOYED SIX CERTIFIED APPLICATION COUNSELORS TO ASSIST INDIVIDUALS WITH ENROLLMENT IN THE HEALTH INSURANCE EXCHANGE. Form 990, Part VI, Line 11b Review of form 990 by governing body 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. THE CEO AND CFO REVIEW THE RETURN BEFORE IT IS PRESENTED TO THE FINANCE COMMITTEE. THE FINANCE COMMITTEE APPROVES THE RETURN, AND THE FINANCE COMMITTEE CHAIR MAKES A RECOMMENDATION TO THE BOARD FOR APPROVAL OF THE FORM 990 FOR FILING WITH THE IRS. BOARD MEMBERS RECEIVE THE FORM 990 AS HARD COPIES (MAILED OR HAND-DELIVERED) OR ELECTRONIC FILES (SENT VIA E-MAIL). Form 990, Part VI, Line 12c Conflict of interest policy A CONFLICT OF INTEREST POLICY IS STATED IN THE EMPLOYEE HANDBOOK. PER THE BYLAWS, IF A QUESTION CONCERNING A CONFLICT OF INTEREST FOR ANY DIRECTOR IS RAISED, A WRITTEN SECRET BALLOT MAY BE USED BY THE REMAINING DIRECTORS TO DETERMINE IF SUCH CONFLICT OF INTEREST EXISTS. SHOULD A CONFLICT OF INTEREST, PECUNIARY OR OTHERWISE, BE DETERMINED FOR ANY DIRECTOR, SUCH DIRECTOR SHALL BE EXCLUDED FROM VOTING ON THAT SUBJECT MATTER. A SIMPLE, AFFIRMATIVE MAJORITY OF THOSE PRESENT SHALL RULE. IN ALL EVENTS, A DIRECTOR SHALL DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE CEO'S COMPENSATION WAS EVALUATED IN 2023 BY THE EXECUTIVE BOARD OF DIRECTORS USING A COMPREHENSIVE CEO PERFORMANCE EVALUATION TOOL. THE EXECUTIVE BOARD ASSESSED THE CEO'S INDIVIDUAL PERFORMANCE, THE ORGANIZATION'S PERFORMANCE, AND WHETHER THE CEO ACCOMPLISHED THE MUTUALLY-AGREED UPON OBJECTIVES FOR THE FISCAL YEAR BEING REVIEWED. THE HR DIRECTOR CONDUCTS AN IN-DEPTH SALARY ANALYSIS ON A BI-ANNUAL BASIS WITH A CURSORY ANALYSIS DURING THE ALTERNATE YEARS. THE DATA USED IS OBTAINED LOCALLY, REGIONALLY, AND NATIONALLY. THIS ANALYSIS IS COMPILED AND A RECOMMENDATION IS TAKEN TO THE EXECUTIVE BOARD. THE CEO'S ANNUAL PERFORMANCE EVALUATION IS CALCULATED BY THE EXECUTIVE BOARD TO DETERMINE THE CURRENT YEAR SALARY, AND THE SALARY ANALYSIS IS COMPARED TO ENSURE THAT THE SALARY IS APPROPRIATE FOR THE POSITION AND PERFORMANCE. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS WILL BE PROVIDED TO INQUIRING PARTIES UPON REQUEST.