STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

SIOUXLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
SIOUXLAND COMMUNITY HEALTH CENTER (EIN 42-1374894)
Tax period
2017-02-01 to 2018-01-31
Filed
2018-10-31
IRS object ID
201813049349300916
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2018-10-31T08:56:14-05:00ReturnTs
Tax Period End2018-01-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-02-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421374894EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SIOUXLAND COMMUNITY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JAN ANDERSON CFOInCareOfNm
Business Name ControlSIOUBusinessNameControlTxt
Phone7122512477PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11021 NEBRASKA STREETAddressLine1Txt
CitySIOUX CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51105ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARI KAPTAIN-DAHLENPersonNm
Person TitleCEOPersonTitleTxt
Signature2018-08-03SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKrystal K CreachPreparerPersonNm
PTINP00422601PTIN
Phone4178658701PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id43032920183045000000FederalOriginalSubmissionId
Federal Original Submission Id2018-10-31FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id35B2FEF9FD89B74F90B63698513A1BB518488CA1AtSubmissionCreationDeviceId
At Submission Filing Device Id92996119D705B961BF1767000FEBD157C9C05609AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARI KAPTAIN-DAHLENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11021 NEBRASKA STREETAddressLine1Txt
CitySIOUX CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51105ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$28,927,153GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SLANDCHC.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO BE A PATIENT-CENTERED MEDICAL HOME THAT IMPROVES THE PHYSICAL, DENTAL, AND BEHAVIORAL HEALTH OF THE SIOUXLAND COMMUNITY WHILE ELIMINATING ACCESS BARRIERS.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee304TotalEmployeeCnt
Total Volunteers17TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,776,438PYContributionsGrantsAmt
CY Contributions Grants$6,185,636CYContributionsGrantsAmt
PY Program Service Revenue$21,582,502PYProgramServiceRevenueAmt
CY Program Service Revenue$22,589,917CYProgramServiceRevenueAmt
PY Investment Income$31,233PYInvestmentIncomeAmt
CY Investment Income$103,083CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$48,517CYOtherRevenueAmt
PY Total Revenue$27,390,173PYTotalRevenueAmt
CY Total Revenue$28,927,153CYTotalRevenueAmt
PY Grants And Similar Paid$357,825PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$156,713CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$15,876,657PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,742,611CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,818,718PYOtherExpensesAmt
CY Other Expenses$8,381,591CYOtherExpensesAmt
PY Total Expenses$24,053,200PYTotalExpensesAmt
CY Total Expenses$25,280,915CYTotalExpensesAmt
PY Revenues Less Expenses$3,336,973PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,646,238CYRevenuesLessExpensesAmt
Total Assets BOY$24,827,569TotalAssetsBOYAmt
Total Assets EOY$29,215,477TotalAssetsEOYAmt
Total Liabilities BOY$7,247,868TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,793,855TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$17,579,701NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$21,421,622NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE SERVE OUR COMMUNITY TO BRING HEALING THROUGH OUR COMMITMENT TO CARE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$13,741,094ExpenseAmt
Grant$156,713GrantAmt
Revenue$14,909,345RevenueAmt
DescPRIMARY AND SPECIALTY MEDICAL SERVICES FOR FYE 2018, SCHC PROVIDED MEDICAL, PRENATAL, AND BEHAVIORAL HEALTH SERVICES FOR 75,623 PATIENT VISITS. SERVICES WERE PROVIDED BY SIX PRIMARY CARE PHYSICIANS, EIGHT PHYSICIAN ASSISTANTS, TWELVE NURSE PRACTITIONERS, AND A VARIETY OF VOLUNTEER SPECIALTY PROVIDERS FROM THE SIOUXLAND COMMUNITY. SPECIALTY CARE VOLUNTEERS PROVIDED THE FOLLOWING CARE: CARDIOVASCULAR, SURGERY, PODIATRY, OPTOMETRY AND NEPHROLOGY. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,955,770ExpenseAmt
Revenue$4,292,084RevenueAmt
DescPHARMACY THE SCHC PHARMACY IS AVAILABLE TO ALL PATIENTS RECEIVING HEALTH CARE SERVICES AT THE HEALTH CENTER. THREE PHARMACISTS ARE ON STAFF TO OFFER MEDICATION COUNSELING FOR PRESCRIPTIONS. IN ADDITION, THE HEALTH CENTER EMPLOYED ONE 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. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$3,122,976ExpenseAmt
Revenue$3,388,488RevenueAmt
DescDENTAL CARE SCHC EMPLOYED FOUR DENTISTS AND FOUR 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 17,931 PATIENT VISITS DURING THE YEAR ENDING 1/31/18.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$20,819,840TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document64IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee304EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJAN ANDERSON CFOPersonNm
Phone7122522477PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11021 NEBRASKA STREETAddressLine1Txt
CitySIOUX CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51105ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ANDREA BUCKLEY
VICE PRESIDENT1.00.0Yes (X)Yes (X)$0$0$0
JENNIFER GOMEZ
SECRETARY1.00.0Yes (X)Yes (X)$0$0$0
DAVID OLSON
PRESIDENT1.00.0Yes (X)Yes (X)$0$0$0
DONA PRINCE
TREASURER1.00.0Yes (X)Yes (X)$0$0$0
BIBI GAZNABBI-JAURON
DIRECTOR1.00.0Yes (X)$0$0$0
KELLEY MCCARTHY
DIRECTOR1.00.0Yes (X)$0$0$0
OMAR SUAREZ
DIRECTOR1.00.0Yes (X)$0$0$0
CHAD MARKHAM
DIRECTOR1.00.0Yes (X)$0$0$0
AMY SLEVIN
DIRECTOR1.00.0Yes (X)$0$0$0
JAY ROSENBERG
DIRECTOR1.00.0Yes (X)$0$0$0
FRANK LAMERE
DIRECTOR1.00.0Yes (X)$0$0$0
JEFFREY DEAN
DIRECTOR1.00.0Yes (X)$0$0$0
JENNIFER BRAVANTE BURKHART
DIRECTOR1.00.0Yes (X)$0$0$0
ABDULLAHI URUR
DIRECTOR BEG 04/171.00.0Yes (X)$0$0$0
MARI KAPTAIN-DAHLEN
CEO40.00.0Yes (X)$200,186$0$10,532
MICHAEL PIPLANI MD
CMO40.00.0Yes (X)$289,248$0$18,864
JAN ANDERSON CPA MBA
CFO40.00.0Yes (X)$172,577$0$27,474
BRENDA HAUSMAN-MILLER DDS
DENTAL DIRECTOR40.00.0$229,336$0$29,334Yes (X)
DAVID FALDMO PA
QUALITY DIRECTOR40.00.0$261,552$0$40,504Yes (X)
DYLAN GREENE MD
PHYSICIAN40.00.0$273,646$0$32,821Yes (X)
TYLER WENDEL MD
PHYISICIAN40.00.0$279,206$0$22,468Yes (X)
ANN PICK
NP40.00.0$192,229$0$27,448Yes (X)
KRISTI WALZ MD
PHYSICIAN40.00.0$270,569$0$30,716Yes (X)
GARY HATTAN MD
PHYSICIAN40.00.0$269,637$0$37,392Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,438,186TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$277,553TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K33IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
INCONCERT CARE INC
9943 HICKMAN RD STE 103URBANDLEIA50322COMPUTER SERVICES$427,594
SIOUXLAND MEDICAL EDUCATION FOUNDAT
2501 PIERCE STREETSIOUX CITYIA51104PHYSICIANS-PRENATAL$332,680
QUEST DIAGNOSTICS
PO BOX 14730ST LOUISMO63150LAB TESTING$220,395
BKD LLP
910 E ST LOUIS ST STE 200SPRINGFIELDMO65810AUDIT/TAX/CONSULTING$130,520
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
Government Grants$5,966,389GovernmentGrantsAmt
All Other Contributions$219,247AllOtherContributionsAmt
Noncash Contributions$646,528NoncashContributionsAmt
Total Contributions$6,185,636TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE624100$22,129,319$22,129,319
EHR INCENTIVE REVENUE624100$293,250$293,250
OTHER REVENUE624100$167,348$167,348
FieldValueIRS element (for citing)
Total Program Service Revenue$22,589,917TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$103,083TotalRevenueColumnAmt
Exclusion$103,083ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescGAIN ON EQUITY INVESTEEDesc
Business900099BusinessCd
Total Revenue Column$48,517TotalRevenueColumnAmt
Exclusion$48,517ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$48,517OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,927,153TotalRevenueColumnAmt
Related Or Exempt Func Income$22,589,917RelatedOrExemptFuncIncomeAmt
Exclusion$151,600ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$80,201TotalAmt
Program Services$80,201ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$76,512TotalAmt
Program Services$76,512ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,279,607TotalAmt
Program Services$868,838ProgramServicesAmt
Management And General$410,769ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,791,398TotalAmt
Program Services$10,649,803ProgramServicesAmt
Management And General$2,141,595ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$504,851TotalAmt
Program Services$423,655ProgramServicesAmt
Management And General$81,196ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,213,874TotalAmt
Program Services$1,005,741ProgramServicesAmt
Management And General$208,133ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$952,881TotalAmt
Program Services$781,063ProgramServicesAmt
Management And General$171,818ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$26,163TotalAmt
Management And General$26,163ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$137,077TotalAmt
Management And General$137,077ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,650,106TotalAmt
Program Services$1,480,742ProgramServicesAmt
Management And General$169,364ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$92,854TotalAmt
Management And General$92,854ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$617,476TotalAmt
Program Services$368,234ProgramServicesAmt
Management And General$249,242ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$209,497TotalAmt
Program Services$157,844ProgramServicesAmt
Management And General$51,653ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$275,058TotalAmt
Program Services$225,922ProgramServicesAmt
Management And General$49,136ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$31,369TotalAmt
Program Services$26,958ProgramServicesAmt
Management And General$4,411ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$414,224TotalAmt
Program Services$253,113ProgramServicesAmt
Management And General$161,111ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$237,538TotalAmt
Program Services$4,139ProgramServicesAmt
Management And General$233,399ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$791,256TotalAmt
Program Services$646,310ProgramServicesAmt
Management And General$144,946ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$44,829TotalAmt
Program Services$35,509ProgramServicesAmt
Management And General$9,320ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$2,873,610$2,873,610
BAD DEBT$787,373$787,373
LICENSES, DUES, SUBSCRIPTIONS$138,867$74,273$64,594
RECRUITING & RETENTION$28,989$28,989

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$25,305TotalAmt
Management And General$25,305ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$25,280,915TotalAmt
Program Services$20,819,840ProgramServicesAmt
Management And General$4,461,075ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$188,448BOYAmt
EOY$359,225EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$10,197,428BOYAmt
EOY$13,713,370EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,082,038BOYAmt
EOY$900,163EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,770,382BOYAmt
EOY$2,710,680EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$199,212BOYAmt
EOY$208,004EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$116,746BOYAmt
EOY$115,349EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,366,351LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,410,515LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,158,982BOYAmt
EOY$10,955,836EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$14,333BOYAmt
EOY$62,850EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$100,000BOYAmt
EOY$190,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$24,827,569BOYAmt
EOY$29,215,477EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,861,081BOYAmt
EOY$2,492,396EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,728,350BOYAmt
EOY$4,388,705EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$658,437BOYAmt
EOY$912,754EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,247,868BOYAmt
EOY$7,793,855EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,446,901BOYAmt
EOY$21,282,930EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$132,800BOYAmt
EOY$138,692EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,579,701BOYAmt
EOY$21,421,622EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$24,827,569BOYAmt
EOY$29,215,477EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,646,238ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$195,683NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,693,098CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,424,315CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,731,092CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,776,438CurrentTaxYearMinus1YearAmt
Current Tax Year$6,185,636CurrentTaxYearAmt
Total$26,810,579TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,693,098CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,424,315CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,731,092CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,776,438CurrentTaxYearMinus1YearAmt
Current Tax Year$6,185,636CurrentTaxYearAmt
Total$26,810,579TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$387,986SubstantialContributorsTotAmt
Public Support Total170$26,422,593PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,583CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,401CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$19,427CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$31,233CurrentTaxYearMinus1YearAmt
Current Tax Year$103,083CurrentTaxYearAmt
Total$169,727TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$26,980,306TotalSupportAmt
Gross Receipts Rltd Activities$95,765,438GrossReceiptsRltdActivitiesAmt
Public Support CY1700.97933PublicSupportCY170Pct
Public Support PY1700.94369PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1(I)FormAndLineReferenceDesc
ExplanationOTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAID DUES OF $20,000 TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND $34,108 TO THE IOWA PRIMARY CARE ASSOCIATION. A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,271,327OtherCostOrOtherBasisAmt
Book Value$1,271,327BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,556,349OtherCostOrOtherBasisAmt
Depreciation$4,387,010DepreciationAmt
Book Value$8,169,339BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,337,946OtherCostOrOtherBasisAmt
Depreciation$2,023,505DepreciationAmt
Book Value$1,314,441BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$200,729OtherCostOrOtherBasisAmt
Book Value$200,729BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$10,955,836TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
INTEREST RATE SWAP$462,754
EST. DUE TO THIRD PARTIES$450,000
FieldValueIRS element (for citing)
Total Liability$912,754TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$28,335,071TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$195,683NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$5,500DonatedServicesAndUseFcltsAmt
Other Revenue-$148,460OtherRevenueAmt
Revenue Not Reported$52,723RevenueNotReportedAmt
Revenue Subtotal$28,282,348RevenueSubtotalAmt
Other Revenues Not Included$644,805OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$644,805RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$28,927,153TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$24,499,042TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$5,500DonatedServicesUseFcltsAmt
Expenses Not Reported$5,500ExpensesNotReportedAmt
Expenses Subtotal$24,493,542ExpensesSubtotalAmt
Other Expenses Not Included$787,373OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$787,373ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$25,280,915TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2UNCERTAIN 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 2DAMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ (787,373) BAD DEBT EXPENSE 638,913 NET ASSETS RELEASED FROM RESTRICTION ----------- $ (148,460)
SCHEDULE D, PART XI, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 644,805 TEMPORARILY RESTRICTED CONTRIBUTIONS
SCHEDULE D, PART XII, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 787,373 BAD DEBT EXPENSE

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
NEBRASKA AIDS PROJECT
250 S 77TH STREET SUITE AOMAHANE68114470786622501(C)(3)$49,723HIV CASE MANAGE
JACKSON RECOVERY CENTERS
800 5TH STREETSIOUX CITYIA51101391900255501(C)(3)$30,219BEHAVIOR CASE MANAGE
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeRENTAL ASSITANCE PROGRAMGrantTypeTxt
Recipient35RecipientCnt
Cash Grant$75,626CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationMONITORING OF GRANT FUNDS: NEBRASKA AIDS PROJECT CONTINUED TO BE A SUBCONTRACTED AGENCY IN ORDER TO PROVIDE CONTRACTUAL HIV/AIDS SERVICES IN SOUTHWEST IA. THEY WERE CHOSEN ON THE BASIS OF PRIOR EXPERIENCE WITH WORKING WITH TARGETED POPULATION, AND STAFF CREDENTIALS/EXPERIENCE. THE AGENCY SUBMITS MONTHLY FINANCIAL REPORTS WITH EXPENSE DOCUMENTATION AND TIME TRACKING IN ORDER TO BE REIMBURSED. THEY ALSO SUBMIT THEIR ANNUAL AUDIT FOR REVIEW AND AN ON-SITE MONITORING REVIEW IS PERFORMED ANNUALLY. JACKSON RECOVERY CENTERS WAS SELECTED TO BE A SUBCONTRACTED AGENCY TO PROVIDE ON-SITE BEHAVIORAL HEALTH CASE MANAGEMENT SERVICES. JACKSON RECOVERY CENTERS WAS SELECTED BASED ON PRIOR EXPERIENCE WITH WORKING WITH THE TARGETED POPULATION. JACKSON RECOVERY CENTERS STAFF MAINTAINS TIME AND EFFORT RECORDS AND SUBMITS MONTHLY INVOICES FOR SERVICES. STAFF ARE SUPERVISED AND EVALUATED BY THE HEALTH CENTER CHIEF MEDICAL OFFICER. PATIENTS WITHIN THE HIV PROGRAM HAVE THE POTENTIAL OF QUALIFYING FOR THE RENTAL ASSISTANCE PROGRAM. THIS IS A SERVICE PROVIDED BY SIOUXLAND COMMUNITY HEALTH CENTER TO INDIVIDUALS WHO QUALIFY. INDIVIDUALS MUST DEMONSTRATE A NEED FOR FINANCIAL ASSISTANCE AND THEY MUST FOLLOW-UP REGULARLY WITH THE STAFF AT THE CLINIC.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MARI KAPTAIN-DAHLEN
CEO$190,319$0$1,000$0$8,867$0$9,910$0$622$0$210,718$0$0$0
MICHAEL PIPLANI MD
CMO$279,028$0$6,300$0$3,920$0$13,500$0$5,364$0$308,112$0$0$0
JAN ANDERSON CPA MBA
CFO$164,157$0$1,000$0$7,420$0$8,944$0$18,530$0$200,051$0$0$0
DYLAN GREENE MD
PHYSICIAN$240,740$0$32,743$0$163$0$12,694$0$20,127$0$306,467$0$0$0
TYLER WENDEL MD
PHYISICIAN$239,884$0$35,573$0$3,749$0$13,500$0$8,968$0$301,674$0$0$0
ANN PICK
NP$163,564$0$24,000$0$4,665$0$8,778$0$18,670$0$219,677$0$0$0
BRENDA HAUSMAN-MILLER DDS
DENTAL DIRECTOR$216,064$0$8,010$0$5,262$0$4,160$0$25,174$0$258,670$0$0$0
DAVID FALDMO PA
QUALITY DIRECTOR$209,552$0$41,300$0$10,700$0$13,500$0$27,004$0$302,056$0$0$0
KRISTI WALZ MD
PHYSICIAN$248,486$0$12,950$0$9,133$0$13,500$0$17,216$0$301,285$0$0$0
GARY HATTAN MD
PHYSICIAN$257,900$0$6,000$0$5,737$0$13,500$0$23,892$0$307,029$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 7FormAndLineReferenceDesc
ExplanationNONFIXED PAYMENTS: MONTHLY OR QUARTERLY INCENTIVE PAYMENTS BASED ON PRODUCTION ARE PAID TO EMPLOYEES SUBJECT TO THE DISCRETION OF THE BOARD OF DIRECTORS.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WOODBURY COUNTY IOWABusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN426005221BondIssuerEIN
Bond Issued2007-09-25BondIssuedDt
Issue Price$7,000,000IssuePriceAmt
PurposeCONSTRUCTION OF NEW FACILITYPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$2,924,592RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$7,000,000TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$100,000IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$6,900,000WorkingCapitalExpendituresAmt
Capital Expenditures$0CapitalExpendituresAmt
Other Spent Proceeds$0OtherSpentProceedsAmt
Unspent$0UnspentAmt
Substantial Completion2009SubstantialCompletionYr
Current RefundingfalseCurrentRefundingInd
Advance RefundingfalseAdvanceRefundingInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Bond Iss Meet Prvt Sec Pymt TestYes (true)BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DueYes (true)NoRebateDueInd
Variable Rate IssueYes (true)VariableRateIssueInd
Hedge Identified In Bks And RecYes (true)HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line1WELLS FARGOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Term Of Hedge20.TermOfHedgePct
Superintegrated HedgefalseSuperintegratedHedgeInd
Hedge TerminatedfalseHedgeTerminatedInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE K, PART IV, LINE 2CFormAndLineReferenceDesc
ExplanationNO REBATE DUE: THE COMPUTATION WAS PERFORMED AS OF 11/25/2012.ExplanationTxt

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp
Clothing And Household GoodsClothingAndHouseholdGoodsGrp
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp
Securities Publicly TradedSecuritiesPubliclyTradedGrp
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp
CollectiblesCollectiblesGrp
Food InventoryFoodInventoryGrp

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution5ContributionCnt
Noncash Contributions Rpt F990$646,528NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE M, PART I, LINE 20, COLUMN (B)FormAndLineReferenceDesc
ExplanationNUMBER OF CONTRIBUTIONS: THE NUMBERS ENTERED IN COLUMN B REPRESENT THE NUMBER OF DONORS WHO CONTRIBUTED THESE ITEMS DURING THE YEAR.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 4PROGRAM 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, 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 4APROGRAM SERVICE ACTIVITY #1: LABORATORY SIOUXLAND COMMUNITY HEALTH CENTER CURRENTLY CONDUCTS APPROXIMATELY 91% 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 FOR THE YEAR ENDING 1/31/18, THE LABORATORY PERFORMED 31,759 TESTS. RADIOLOGY SCHC ALSO CONDUCTS RADIOLOGY SERVICES. IT PERFORMED 3,331 EXAMS FOR THE YEAR ENDING 1/31/18. HIV/AIDS AND HEPATITIS THE HIV TEAM SERVES THE TRI-STATE SIOUXLAND AREA, AS WELL AS 18 NORTHWEST IOWA COUNTIES, 4 COUNTIES IN NEBRASKA, AND 3 COUNTIES IN SOUTH DAKOTA. APPROXIMATELY 48% 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 1/31/18, THE HIV TEAM SERVED 168 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. IN 2017, 14% OF PATIENTS RECEIVING CARE WERE UNINSURED, 48% HAD COVERAGE BY MEDICAID/HAWK-I, 13% HAD MEDICARE COVERAGE, AND 25% HAD COVERAGE BY OTHER PAYERS. SCHC EMPLOYED FOUR CERTIFIED APPLICATION COUNSELORS TO ASSIST INDIVIDUALS WITH ENROLLMENT IN THE HEALTH INSURANCE EXCHANGE.
FORM 990, PART III, LINE 4CPROGRAM SERVICE ACTIVITY #3: THE SCHC PHARMACY ALSO PARTICIPATES IN OTHER PHARMACEUTICAL ASSISTANCE PROGRAMS TO ENSURE PATIENTS HAVE ACCESS TO NEEDED PRESCRIPTION DRUGS.
FORM 990, PART VI, SECTION B, LINE 11BREVIEW OF THE FORM 990: 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, SECTION B, LINE 12CCONFLICT 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, SECTION B, LINE 15ACEO COMPENSATION REVIEW: THE CEO'S COMPENSATION WAS EVALUATED IN 2017 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, SECTION B, LINE 15BOTHER OFFICER COMPENSATION REVIEW: THE CFO'S AND THE CMO'S COMPENSATION WAS EVALUATED IN 2017 BY THE CEO USING A COMPREHENSIVE PERFORMANCE EVALUATION TOOL. THE CEO ASSESSED THE CFO'S AND THE CMO'S INDIVIDUAL PERFORMANCE, THE ORGANIZATION'S PERFORMANCE, AND WHETHER THE CFO AND THE CMO ACCOMPLISHED THE MUTUALLY AGREED UPON OBJECTIVES FOR THE FISCAL YEAR BEING REVIEWED.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS WILL BE PROVIDED TO INQUIRING PARTIES UPON REQUEST.