STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

KENOSHA COMMUNITY HEALTH CENTER INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
KENOSHA COMMUNITY HEALTH CENTER INC (EIN 39-1789874)
Tax period
2016-03-01 to 2017-02-28
Filed
2018-01-16
IRS object ID
201820169349300147
Schema version
2016v3.0
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)
Return2018-01-16T14:44:48-06:00ReturnTs
Tax Period End2017-02-28TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Wipfli LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110000 Innovation Drive Suite 250AddressLine1Txt
CityMilwaukeeCityNm
State AbbreviationWIStateAbbreviationCd
ZIP532264837ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-03-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391789874EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Kenosha Community Health Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlKENOBusinessNameControlTxt
Phone2627643608PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1625 57th Street No 700AddressLine1Txt
CityKenoshaCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53140ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBrent RaffertyPersonNm
Person TitleChief Executive OfficerPersonTitleTxt
Phone2627643608PhoneNum
Signature2018-01-16SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVE GLOBIGPreparerPersonNm
PTINP01356041PTIN
Phone4144319300PhoneNum
Preparation2018-01-16PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address207.250.78.130IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-01-16IPDt
IP Tm14:44:46IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id51EE487FFA723F16933CF5B8BD3577F2E9FFA893AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBrent RaffertyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1625 57th Street No 700AddressLine1Txt
CityKenoshaCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53140ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,920,725GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.kenoshachc.orgWebsiteAddressTxt
Type Of Organization AssocYes (X)TypeOfOrganizationAssocInd
Formation1994FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTo establish, maintain and operate a health center in order to provide primary care & referral health services to disadvantaged & underserved populations in Kenosha, Wisconsin; and to promote, foster and ensure that basic primary health services are available & accessible to uninsured and/or underinsured residents of Kenosha, Wisconsin in coordination with other levels of health care and support services in the community.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee156TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,376,140PYContributionsGrantsAmt
CY Contributions Grants$2,846,771CYContributionsGrantsAmt
PY Program Service Revenue$11,135,490PYProgramServiceRevenueAmt
CY Program Service Revenue$7,902,861CYProgramServiceRevenueAmt
PY Investment Income$458PYInvestmentIncomeAmt
CY Investment Income$154CYInvestmentIncomeAmt
PY Other Revenue$29,248PYOtherRevenueAmt
CY Other Revenue$170,939CYOtherRevenueAmt
PY Total Revenue$13,541,336PYTotalRevenueAmt
CY Total Revenue$10,920,725CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,829,441PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,128,297CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,847,406PYOtherExpensesAmt
CY Other Expenses$4,582,695CYOtherExpensesAmt
PY Total Expenses$12,676,847PYTotalExpensesAmt
CY Total Expenses$11,710,992CYTotalExpensesAmt
PY Revenues Less Expenses$864,489PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$790,267CYRevenuesLessExpensesAmt
Total Assets BOY$10,384,641TotalAssetsBOYAmt
Total Assets EOY$9,467,156TotalAssetsEOYAmt
Total Liabilities BOY$3,982,270TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,855,052TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,402,371NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,612,104NetAssetsOrFundBalancesEOYAmt
MissionTo provide access to comprehensive health care services and to reduce health disparities for the underserved people of Kenosha County, Wisconsin, without regard to ability to pay and in a sustainable manner.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,691,892ExpenseAmt
Grant$0GrantAmt
Revenue$4,519,553RevenueAmt
DescIncrease access to comprehensive dental care for Medicaid enrollees and the uninsured.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,199,182ExpenseAmt
Grant$0GrantAmt
Revenue$2,515,626RevenueAmt
DescIncrease access to comprehensive medical and behavioral health care for Medicaid enrollees and the uninsured.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$739,826ExpenseAmt
Grant$0GrantAmt
Revenue$871,705RevenueAmt
DescIncrease access to comprehensive behavioral health care for Medicaid enrollees and the uninsured.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$335,602ExpenseAmt
Revenue$148,711RevenueAmt
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$335,602TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$148,711TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$8,966,502TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee156EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jeffery GrantBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2627643608PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1625 57th Street Suite 700AddressLine1Txt
CityKenoshaCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53140ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Nancy McCoy
Board Member1.00Yes (X)$0$0$0
Joseph Michaelis
Board Member1.00Yes (X)$0$0$0
Covetrus O'Neal
Board Member1.00Yes (X)$0$0$0
Nancy Phillips
Board Member1.00Yes (X)$0$0$0
Roxane Rohani
Board Member/Quality Chair1.00Yes (X)$0$0$0
Shebaniah Muhammad
President1.00Yes (X)$0$0$0Yes (X)
Nicole Bardwell
Vice President1.00Yes (X)$0$0$0Yes (X)
William Roberts
Secretary1.00Yes (X)$0$0$0Yes (X)
Daniel Heyden
Treasurer1.00Yes (X)$0$0$0Yes (X)
Mary Coffey
Chief Executive Officer40.00$159,752$0$16,261Yes (X)
Julia Harris Robinson
CFO (Thru 5/27/16)40.00$50,502$0$8,680Yes (X)
Arthur Jablonski
Interim CFO (5/3/16 - 9/22/16)40.00$80,000$0$0Yes (X)
Sheila Moran
Interim CFO (BEG 9/26/16)40.00$60,000$0$0Yes (X)
Alan Marshall
Chief Operation Officer40.00$58,087$0$5,724Yes (X)
Joseph Barta
Dentist40.00$149,178$0$18,241Yes (X)
David Connell
Dentist40.00$155,702$0$0Yes (X)
Thomas Jazwiecki
Dentist40.00$143,985$0$4,080Yes (X)
Sapna Patel
Physician40.00$172,738$0$1,431Yes (X)
Phuoc Vuong
Dentist40.00$140,559$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,170,503TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$54,417TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K8IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Office Team
12400 Collections Center DriveChicagoIL60693Staffing Agency$264,481
Greenway Health
PO Box 204485DallasTX75320Electronic Healthcare System$251,610
Patterson Dental Supply
N30 W22383 Green RoadWaukesahWI53186Dental Supplies & Services$230,909
Lifeline Mobile
2050 McGaw RoadColumbusOH43310Mobile Unit$205,893
McKesson Medical
One Post StreetSan FranciscoCA94104Medical Supplies$183,938
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K10CntrctRcvdGreaterThan100KCnt
Government Grants$2,453,297GovernmentGrantsAmt
All Other Contributions$393,474AllOtherContributionsAmt
Noncash Contributions$335,602NoncashContributionsAmt
Total Contributions$2,846,771TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient Service FeesDesc
Business621110BusinessCd
Total Revenue Column$7,902,861TotalRevenueColumnAmt
Related Or Exempt Func Income$7,902,861RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$7,902,861TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$154TotalRevenueColumnAmt
Exclusion$154ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$170,939TotalRevenueColumnAmt
Related Or Exempt Func Income$152,734RelatedOrExemptFuncIncomeAmt
Exclusion$18,205ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$170,939OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,920,725TotalRevenueColumnAmt
Related Or Exempt Func Income$8,055,595RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$18,359ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$472,606TotalAmt
Management And General$472,606ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,168,647TotalAmt
Program Services$4,715,531ProgramServicesAmt
Management And General$453,116ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$180,136TotalAmt
Program Services$147,735ProgramServicesAmt
Management And General$32,401ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$797,868TotalAmt
Program Services$676,973ProgramServicesAmt
Management And General$120,895ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$509,040TotalAmt
Program Services$432,610ProgramServicesAmt
Management And General$76,430ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$69,970TotalAmt
Management And General$69,970ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$92,211TotalAmt
Program Services$27,654ProgramServicesAmt
Management And General$64,557ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,278,169TotalAmt
Program Services$431,105ProgramServicesAmt
Management And General$847,064ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$14,710TotalAmt
Program Services$10,082ProgramServicesAmt
Management And General$4,628ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$761,156TotalAmt
Program Services$490,492ProgramServicesAmt
Management And General$270,664ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$122,660TotalAmt
Program Services$122,660ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$596,211TotalAmt
Program Services$455,565ProgramServicesAmt
Management And General$140,646ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$15,728TotalAmt
Program Services$6,512ProgramServicesAmt
Management And General$9,216ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$43,819TotalAmt
Program Services$27,475ProgramServicesAmt
Management And General$16,344ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$116,989TotalAmt
Management And General$116,989ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$597,101TotalAmt
Program Services$577,420ProgramServicesAmt
Management And General$19,681ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$26,102TotalAmt
Program Services$17,427ProgramServicesAmt
Management And General$8,675ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical & Lab Supplies$814,237$814,237
Dues & Subscriptions$20,051$5,064$14,987

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$13,581TotalAmt
Program Services$7,960ProgramServicesAmt
Management And General$5,621ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$11,710,992TotalAmt
Program Services$8,966,502ProgramServicesAmt
Management And General$2,744,490ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,008,519BOYAmt
EOY$715,616EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$103BOYAmt
EOY$103EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$90,340BOYAmt
EOY$395,429EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,480,416BOYAmt
EOY$3,260,262EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$193,341BOYAmt
EOY$194,317EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,633,388LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,731,959LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,470,097BOYAmt
EOY$4,901,429EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$141,825BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,384,641BOYAmt
EOY$9,467,156EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,077,680BOYAmt
EOY$1,217,781EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$160,204BOYAmt
EOY$147,998EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$30,098BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,714,288BOYAmt
EOY$2,489,273EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,982,270BOYAmt
EOY$3,855,052EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,393,399BOYAmt
EOY$5,612,104EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,972BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,402,371BOYAmt
EOY$5,612,104EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,384,641BOYAmt
EOY$9,467,156EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$790,267ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)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$1,670,762CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,455,056CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,770,345CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,367,140CurrentTaxYearMinus1YearAmt
Current Tax Year$2,846,771CurrentTaxYearAmt
Total$10,110,074TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,670,762CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,455,056CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,770,345CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,367,140CurrentTaxYearMinus1YearAmt
Current Tax Year$2,846,771CurrentTaxYearAmt
Total$10,110,074TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$10,110,074PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$491CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$576CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$735CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$458CurrentTaxYearMinus1YearAmt
Current Tax Year$154CurrentTaxYearAmt
Total$2,414TotalAmt
FieldValueIRS element (for citing)
Total Support$10,112,488TotalSupportAmt
Gross Receipts Rltd Activities$49,672,106GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99980PublicSupportCY170Pct
Public Support PY1700.99970PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Beginning Balance$181,473BeginningBalanceAmt
Distributions During Year$33,475DistributionsDuringYearAmt
Ending Balance$147,998EndingBalanceAmt
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$159,200OtherCostOrOtherBasisAmt
Book Value$159,200BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,690,002OtherCostOrOtherBasisAmt
Depreciation$850,483DepreciationAmt
Book Value$2,839,519BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,229,483OtherCostOrOtherBasisAmt
Depreciation$887,890DepreciationAmt
Book Value$1,341,593BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,528,055OtherCostOrOtherBasisAmt
Depreciation$2,993,586DepreciationAmt
Book Value$534,469BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$26,648OtherCostOrOtherBasisAmt
Book Value$26,648BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,901,429TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$10,585,123TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$10,585,123RevenueSubtotalAmt
Other Revenues Not Included$335,602OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$335,602RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$10,920,725TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$11,375,390TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$11,375,390ExpensesSubtotalAmt
Other Expenses Not Included$335,602OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$335,602ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$11,710,992TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IV, Line 2b:The Corporation had an agreement with an unrelated entity to establish and maintain an account that provided funds for breast cancer care through the Kenosha Community Health Center. During the tax year, the corporation returned the funds to the unrelated entity and no longer serves as trustee.
Part X, Line 2:The Organization recognizes the benefits of a tax position only after determining whether it is more likely than not that the taxing authority would sustain the tax position upon examination of the technical merits of the tax position, assuming the taxing authority has full knowledge of all information. The Organization recorded no assets or liabilities related to uncertain tax positions.
Part XI, Line 4b - Other Adjustments:Noncash contributions 335,602.
Part XII, Line 4b - Other Adjustments:Noncash contributions 335,602.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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
Mary Coffey
Chief Executive Officer$159,152$0$0$0$600$0$0$0$16,261$0$176,013$0$0$0
Joseph Barta
Dentist$147,708$0$1,470$0$0$0$0$0$18,241$0$167,419$0$0$0
David Connell
Dentist$155,702$0$0$0$0$0$0$0$0$0$155,702$0$0$0
Sapna Patel
Physician$166,042$0$6,696$0$0$0$0$0$1,431$0$174,169$0$0$0

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution24ContributionCnt
Noncash Contributions Rpt F990$335,602NoncashContributionsRptF990Amt
Method Of Determining RevenuesActual costMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11bThe form is reviewed by the board of directors and the finance committee before it is filed with the Internal Revenue Service.
Form 990, Part VI, Section B, line 12cThe organization requires all new board members to sign a conflict of interest statement. Board members are required to update these statements annually. Should a conflict arise, the person affected is asked to excuse themselves from voting.
Form 990, Part VI, Section B, line 15The organization uses a variety of regional and executive recruiting firms for key employees who recommend compensation packages based on market data. The organization also participates in a variety of compensation surveys through National Association of Community Health Centers, Wisconsin Primary Health Care Association, and generalist Human Resources organizations and receive those reports. There are also periodic spot checks locally for specific positions. Compensation for top management is aproved by the board.
Form 990, Part VI, Section C, line 19The organization makes its governing documents, conflict of interest and financial statements available to the public upon request.
Form 990, Part IX, line 11gOther Fees: Program service expenses 431,105. Management and general expenses 847,064. Fundraising expenses 0. Total expenses 1,278,169.
Form 990, Part XII, Line 2CThe process has not changed from the prior year.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1KCHC Real Estate LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14536 22nd AvenueAddressLine1Txt
CityKenoshaCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53140ZIPCd
FieldValueIRS element (for citing)
EIN391789874EIN
Primary ActivitiesReal estate holdingPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Total Income$232,613TotalIncomeAmt
End Of Year Assets$3,062,788EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Kenosha Community Health Center IncBusinessNameLine1Txt