2019-05-14T12:48:56-05:00 2018-01-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2017-02-01 391550213 NORTHERN HEALTH CENTERS INC NORT 7152766321 PO BOX 179 LAKEWOOD WI 54138 MICHELE WHITE EXECUTIVE DIRECTOR 7152766321 2018-11-02 1 MICHAEL J PETERSON CPA P00023289 7153691040 2018-11-02 64.83.221.74 2018-11-02 09:23:33 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AD09AC63139321B3FD3DE7C115A9F3C08AC4C8C5 2017 2019-02-21 02:37:17Z MICHELE WHITE PO BOX 179 LAKEWOOD WI 54138 5276275 0 X WWW.NHCMEDDEN.COM X 1986 WI TO IMPROVE OUR COMMUNITY HEALTH BY PROVIDING ALL PERSONS A COMPREHENSIVE PROGRAM OF QUALITY FAMILY ORIENTED PRIMARY HEALTH CARE SERVICES REGARDLESS OF ABILITY TO PAY. 6 6 69 9 0 0 1608671 1659430 3619273 3531157 84 106 1718 85582 5229746 5276275 0 0 0 0 2872731 2763470 0 0 0 2206793 2331293 5079524 5094763 150222 181512 2169115 2273408 1025632 948413 1143483 1324995 TO IMPROVE OUR COMMUNITY HEALTH BY PROVIDING ALL PERSONS A COMPREHENSIVE PROGRAM OF QUALITY FAMILY ORIENTED PRIMARY HEALTH CARE SERVICES REGARDLESS OF THEIR ABILITY TO PAY. 0 0 3704560 0 3616157 NORTHERN HEALTH CENTERS, INC. IS A FEDERALLY QUALIFIED HEALTH CENTER LOCATED IN NORTHEAST WISCONSIN. WE ARE A COMMUNITY HEALTH CENTER SERVING A MEDICALLY UNDERSERVED POPULATION WITHIN A FIVE COUNTY RADIUS. THE SERVICES PROVIDED TO OUR PATIENT POPULATION ARE MEDICAL, DENTAL, BEHAVIORAL HEALTH CARE AND ENABLING SERVICES. NHC CONTINUES TO PROVIDE PREVENTIVE DENTAL SERVICES TO THE UNDERSERVED CHILDREN THROUGH OUR SEAL-A-SMILE PROGRAM WHICH WAS IMPLEMENTED IN 2010; WE HAVE INCREASED THE NUMBER OF SCHOOLS WE PROVIDE SEALANTS TO FROM 15 TO 24 SCHOOLS IN THREE COUNTIES. DURING THE 2017 FISCAL YEAR THE ORGANIZATION SERVED 7,937 PATIENTS WITH 19,476 TOTAL VISITS. 3704560 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 34 0 69 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X MICHELE WHITE 7152766321 15397 HWY 32 LAKEWOOD WI 54138 PAAL HANSEN BOARD MEMBER 1.00 X 0 0 0 KATIE HELMSTADLER BOARD MEMBER 1.00 X 0 0 0 JUDITH POPELKA BOARD MEMBER (THRU NOVEMBER) 1.00 X 0 0 0 RAY SCHEIFEN BOARD MEMBER 1.00 X 0 0 0 MARGARAT BLAIR PRESIDENT 1.00 X X 0 0 0 JANICE LIEBSCH VICE PRESIDENT 1.00 X X 0 0 0 JEFFREY WHITING SECRETARY/TREASURER 1.00 X X 0 0 0 MICHELE WHITE EXECUTIVE DIRECTOR 40.00 X 100076 0 3968 HOLLY LIPTACK FINANCE DIRECTOR 40.00 X 74244 0 2143 TED JUNG DENTIST 40.00 X 176100 0 7609 SHARON SHEPICH DOCTOR 40.00 X 128774 0 4550 JOEL SUPITA DENTIST 40.00 X 139419 0 0 GRETCHEN TOLSMA NURSE PRACTITIONER 40.00 X 117574 0 6959 736187 0 25229 5 0 1 0 BARTON ASSOCIATES PO BOX 417844 BOSTON MA 022417844 LOCUM TENAN DENTIST PROVIDER 980056 1 1655930 3500 1659430 MEDICAL & DENTAL SERVI 621110 1925336 1925336 FQHC REIMBURSEMENTS 621110 1605821 1605821 3531157 106 106 MEDICAID MEANINGFUL US 621110 85000 85000 582 582 85582 5276275 3616157 0 688 X 209074 209074 2125479 1561737 563742 32287 23808 8479 218225 28496 189729 178405 111889 66516 8248 8248 25001 25001 1182171 1168929 13242 23080 23080 96581 6856 89725 108450 108450 155695 152785 2910 30678 19757 10921 27552 3733 23819 26964 26964 138177 124359 13818 33566 33566 MEDICAL & DENTAL SUPPLI 329308 329308 SMALL EQUIPMENT EXPENSE 64707 42443 22264 DUES/MEMBERSHIPS 29894 681 29213 RECRUITING EXPENSE 23534 23534 27687 21329 6358 5094763 3704560 1390203 0 29040 0 5385 789 447630 600911 169409 267449 42421 41779 34238 26163 3130754 1798087 1437342 1332667 3650 3650 2169115 2273408 317557 338782 708075 609631 1025632 948413 X 1143483 1324995 1143483 1324995 2169115 2273408 181512 0 X 0 1 X 1 1 1 X 862570 980791 997611 1608671 1659430 6109073 862570 980791 997611 1608671 1659430 6109073 6109073 198 142 213 1799 106 2458 6957 6455 13412 6124943 18140509 0.99740 0.99530 X 0 0 0 0 0 0 0 0 1 5090 5090 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE WISCONSIN PRIMARY HEALTH CARE ASSOCIATION (WPHCA). A PART OF THE MEMBERSHIP DUES PAID TO THE ORGANIZATION IS FOR LOBBYING EXPENDITURES. THE ORGANIZATION ADVOCATES TO ENSURE THAT THE VOICE OF THEIR MEMBERS AND THEIR PATIENTS ARE HEARD LEGISLATIVELY IN ADDITION TO THE MANY OTHER NON-LOBBYING BENEFITS PROVIDED. 84293 84293 861148 428336 432812 659355 155096 504259 1525958 1214655 311303 1332667 X 5270854 0 5270854 5421 5421 5276275 5089342 0 5089342 5421 5421 5094763 PART X, LINE 2: THE ORGANIZATION IS A NON-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM STATE INCOME TAXES. THE ORGANIZATION ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OR THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 5,421. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 5,421. X X 0 0 0 0 0 0 0 0 0 TED JUNG DENTIST 176100 0 0 0 0 0 3193 0 4416 0 183709 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE AUDITING FIRM PRESENTED COMPREHENSIVE AUDIT INFORMATION DIRECTLY TO THE BOARD OF DIRECTORS. A COPY WAS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. THE BOARD REVIEWS AND APPROVES THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C BOTH STAFF AND BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT IDENTIFYING ANY CONFLICTS ON AN ANNUAL BASIS. IF A BOARD MEMBER BELIEVES THAT HE/SHE, A MEMBER OF HIS/HER IMMEDIATE FAMILY OR PARTNER HAS A FINANCIAL INTEREST IN A CONTRACT WITH THE ORGANIZATION, HE/SHE MUST IMMEDIATELY DISCLOSE THIS IN WRITING TO THE BOARD PRESIDENT. NO BOARD MEMBER MAY VOTE ON ANY MATTER WHICH MAY DIRECTLY OR INDIRECTLY RESULT IN FINANCIAL GAIN TO THAT BOARD MEMBER., OR WHICH MAY CONFLICT WITH THAT MEMBER'S OBLIGATIONS TO ANOTHER ORGANIZATION'S BOARD OF DIRECTORS OR TO HI/HER EMPLOYER. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST AND ADDRESSING ANY ISSUES AS A RESULT OF THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY PERFORMANCE COUPLED WITH PREVAILING INDUSTRY STANDARDS AND THE CURRENT NACHC COMPENSATION REPORT. THE COMPENSATION OF THE CEO IS APPROVED BY THE BOARD OF DIRECTORS AND COMPARED TO THE NACHC COMPENSATION REPORT ANNUALLY. THE CFO COMPENSATION IS APPROVED BY THE CEO AND COMPARED TO THE NACHC COMPENSATION REPORT ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUEMNTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMETNS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 93,740. MANAGEMENT AND GENERAL EXPENSES 13,242. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 106,982. LAB SERVICES: PROGRAM SERVICE EXPENSES 89,339. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 89,339. DENTAL SERVICES: PROGRAM SERVICE EXPENSES 985,850. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 985,850.