2017-01-16T00:00:00-06:00 2016-02-29 390758449 Wipfli LLP 10000 Innovation Drive Suite 250 Milwaukee WI 532264837 990 2015-03-01 391789874 Kenosha Community Health Center Inc KENO 2627643608 625 57th Street No 700 Kenosha WI 53140 Mary Coffey Chief Executive Officer 2627643608 2017-01-17 1 DAVE GLOBIG P01356041 4144319300 2017-01-16 2015 2021-01-29 14:40:06Z Mary Coffey 625 57th Street No 700 Kenosha WI 53140 13541336 0 X www.kenoshachc.org X 1994 WI To 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. 11 11 183 11 0 0 1770345 2376140 10138935 11135490 735 458 27385 29248 11937400 13541336 0 0 0 0 8580392 8829441 0 0 0 3360545 3847406 11940937 12676847 -3537 864489 9290230 10384641 3752348 3982270 5537882 6402371 To 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. 0 0 5310240 0 7501825 Increase access to comprehensive dental care for Medicaid enrollees and the uninsured. 3433494 0 2905632 Increase access to comprehensive medical and behavioral health care for Medicaid enrollees and the uninsured. 127114 0 740487 Increase access to comprehensive behavioral health care for Medicaid enrollees and the uninsured. 8870848 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 6 0 1 183 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X Ross Gube 2627643608 625 57th Street Suite 700 Kenosha WI 53140 Joseph Michaelis Board Member 1.00 X 0 0 0 Michael Conforti Board Member 1.00 X 0 0 0 Nancy McCoy Board Member 1.00 X 0 0 0 Nancy Phillips Board Member 1.00 X 0 0 0 Katie Oatsvall Board Member 1.00 X 0 0 0 Covetrus O'Neal Board Member 1.00 X 0 0 0 Roxane Rohani Board Member 1.00 X 0 0 0 Shebaniah Muhammad President 1.00 X X 0 0 0 Nicole Bardwell Vice President 1.00 X X 0 0 0 Daniel Heyden Treasurer 1.00 X X 0 0 0 William Roberts Secretary 1.00 X X 0 0 0 Julia Harris Robinson Chief Financial Officer 40.00 X 113363 0 19402 Mary Coffey Chief Executive Officer 40.00 X 159172 0 24097 Mark Pellegrino Chief Compliance Officer 40.00 X 106206 0 20312 Sapna Patel Physician 40.00 X 190583 0 7609 Karla Iyonmahan Dental Director 40.00 X 173175 0 3242 Thomas Jazwiecki Dentist 40.00 X 165042 0 11943 Joseph Barta Dentist 34.00 X 151587 0 26542 Peter Barbian Medical Director 40.00 X 131879 0 8272 1191007 0 121419 8 0 1 0 Patterson Dental Supply N30 W22383 Green Rd Waukesha WI 53186 Denatl Supplies & Services 349066 Greenway Health PO Box 204485 Dallas TX 75320 Electronic Healthcare System 268773 Aurora Medical Group 8905 W Lincoln Ave Milwaukee WI 53227 Medical Group 209354 McKesson Medical One Post Street San Francisco CA 94104 Medical Supplies 204385 In-House Information Systems 423 Melvin Ave Racine WI 53402 IT Services 179436 10 2367127 9013 2376140 Patient Service Fees 621110 11135490 11135490 11135490 458 458 29248 12454 16794 29248 13541336 11147944 0 17252 386993 386993 6577215 4901456 1675759 192105 126850 65255 1042936 627246 415690 630192 448066 182126 30299 1600 28699 69033 10224 58809 582209 365278 216931 16387 10739 5648 878319 796287 82032 154370 137567 16803 586849 368770 218079 29177 7971 21206 46052 16576 29476 128785 128785 622125 583625 38500 26041 17427 8614 Medical & Lab Supplies 385420 385420 Dues & Subscriptions 25800 12082 13718 Patient Education 8264 8264 258276 45400 212876 12676847 8870848 3805999 0 1485666 1008519 24169 103 131881 90340 1623480 3480416 194733 193341 9604955 4134858 5712578 5470097 117723 141825 9290230 10384641 958403 1077680 0 160204 24169 30098 2769776 2714288 3752348 3982270 X 5495530 6393399 42352 8972 5537882 6402371 9290230 10384641 864489 0 X X 0 1 X 1 1 1 X 4007947 1670762 1455056 1770345 2367140 11271250 4007947 1670762 1455056 1770345 2367140 11271250 11271250 1029 491 576 735 458 3289 11274539 50150900 0.99970 0.99960 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 32169 525200 375896 181473 1 X 159200 159200 3690002 758233 2931769 2229483 740480 1489003 3177645 2636145 541500 348625 348625 5470097 X 13541336 0 13541336 0 13541336 12676847 0 12676847 0 12676847 Part IV, Line 2b: The Corporation entered into an agreement with an unrelated entity to establish and maintain an account that provides funds for breast cancer care through the Kenosha Community Health Center. 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. X X X 0 0 0 0 0 0 0 0 0 Mary Coffey Chief Executive Officer 150693 0 25 0 8454 0 3735 0 20362 0 183269 0 0 0 Sapna Patel Physician 184297 0 25 0 6261 0 5716 0 1893 0 198192 0 0 0 Karla Iyonmahan Dental Director 166628 0 25 0 6522 0 0 0 3242 0 176417 0 0 0 Thomas Jazwiecki Dentist 153803 0 25 0 11214 0 4944 0 6999 0 176985 0 0 0 Joseph Barta Dentist 146053 0 25 0 5509 0 4620 0 21922 0 178129 0 0 0 Form 990, Part VI, Section B, line 11 The 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 12c The 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 15 The 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 19 The organization makes its governing documents, conflict of interest and financial statements available to the public upon request. Form 990, Part XII, Line 2C The process has not changed from the prior year. KCHC Real Estate LLC 4536 22nd Avenue Kenosha WI 53140 391789874 Real estate holding WI 232608 3143389 Kenosha Community Health Center Inc