2016-11-11T14:52:28-06:00 2015-12-31 481032601 ALLEN GIBBS & HOULIK LC 301 N MAIN SUITE 1700 WICHITA KS 672024868 990 2015-01-01 481159633 GRACEMED HEALTH CLINIC INC GRAC 3168662001 1122 N TOPEKA WICHITA KS 67214 DAVID SANFORD CEO 3168662011 2016-11-10 1 JENNIFER A ALLEN P01338336 3162677231 2015 2017-02-10 21:41:12Z DAVID SANFORD 1122 N TOPEKA WICHITA KS 67214 16832257 0 X WWW.GRACEMED.ORG X 1979 KS TO PROVIDE PRIMARY HEALTH AND DENTAL CARE SERVICES TO KANSANS WITHOUT HEALTH INSURANCE OR ADEQUATE FINANCIAL RESOURCES TO SECURE TRADITIONAL HEALTH CARE SERVICES. 16 16 254 60 0 0 4046603 5019173 9463142 10262962 49909 171639 33809 22422 13593463 15476196 0 0 0 0 8417337 9124726 0 0 64567 3290600 3835398 11707937 12960124 1885526 2516072 9901441 13012957 1303094 1478174 8598347 11534783 TO SHOW AND SHARE THE LOVE OF JESUS CHRIST BY PROVIDING COMPASSIONATE, ACCESSIBLE, HIGH-QUALITY HEALTH CARE FOR RESIDENTS OF SOUTH CENTRAL KANSAS. 0 0 10464653 10283859 PROVIDING PRIMARY HEALTH AND DENTAL CARE TO KANSANS WITHOUT HEALTH INSURANCE OR ADEQUATE FINANCIAL RESOURCES TO SECURE TRADITIONAL HEALTH CARE SERVICES 10464653 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 15 0 1 254 1 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 1 0 0 0 KS X DAVID WUTHNOW 3168662049 1122 N TOPEKA WICHITA KS 67214 BARTON PRINCE VICE - PRESIDENT 4.00 X X 0 0 0 MARLON KING TREASURER 4.00 X X 0 0 0 GAIL FINNEY SECRETARY 4.00 X X 0 0 0 MARC MINNIS PRESIDENT 4.00 X X 0 0 0 FRED ERVIN BOARD MEMBER 4.00 X 0 0 0 GAROLD MINNS BOARD MEMBER 4.00 X 0 0 0 JON ROSELL BOARD MEMBER 4.00 X 0 0 0 LAURIE LABARCA BOARD MEMBER 4.00 X 0 0 0 MICHAEL GOOD BOARD MEMBER 4.00 X 0 0 0 ROB DAKIN BOARD MEMBER 4.00 X 0 0 0 SUSAN HOWEY BOARD MEMBER 4.00 X 0 0 0 TERRY BOURLARD BOARD MEMBER 4.00 X 0 0 0 MARCIA NEWTON BOARD MEMBER 4.00 X 0 0 0 GLORIA OSORIO BOARD MEMBER 4.00 X 0 0 0 LAZARO VASQUEZ BOARD MEMBER 4.00 X 0 0 0 JOE WHITAKER BOARD MEMBER 4.00 X 0 0 0 JULIE A ELDER OFFICER 40.00 X 178477 0 10918 VENUS L LEE OFFICER 40.00 X 122340 0 3832 ROGER G NOLTE OFFICER 40.00 X 149898 0 5563 SHAROL A SULLIVAN OFFICER 40.00 X 105089 0 3520 DAVID SANFORD CHIEF EXECUTIVE OFFICER 40.00 X 158667 0 10323 ANDREA M BOOTHE HIGHLY COMPENSATED EMPLOYEE 40.00 X 124240 0 9291 VALERIYA V GREENWOOD HIGHLY COMPENSATED EMPLOYEE 40.00 X 131873 0 9520 JOSHUA TIBBE HIGHLY COMPENSATED EMPLOYEE 40.00 X 108435 0 7737 TEOLINDA A MILSAP HIGHLY COMPENSATED EMPLOYEE 40.00 X 110099 0 11 MADIHA YASIR HIGHLY COMPENSATED EMPLOYEE 40.00 X 114999 0 1739 1304117 0 62454 12 0 1 0 HENRY SCHEIN INC DEPT CH 10241 PALATINE IL 600550241 MEDICAL/DENTAL EQUIPMENT AND SUPPLIES 692462 SCHAEFER JOHNSON COX FREY 257 N BROADWAY WICHITA KS 672022317 ARCHITECTURAL FEES 301839 UNITED HEALTHCARE DEPT CH 10151 PALATINE IL 600550151 EMPLOYER HEALTH INSURANCE 245167 AETNA P O BOX 804735 CHICAGO IL 606804108 EMPLOYER HEALTH INSURANCE 232805 HUTTON CONSTRUCTION CORP 2229 S WEST STREET WICHITA KS 67213 CONSTRUCTION 191895 5 31491 3102059 1885623 5019173 MEDICAL & DENTAL SERVICES 621110 9871962 9871962 HIT CERT INCENTIVE 621110 391000 391000 10262962 29446 29446 1464892 1322699 142193 142193 142193 34887 31491 33362 1525 1525 MISC REVENUE 900099 20897 20897 20897 15476196 10283859 0 173164 X 714471 558677 155794 7680758 5971078 1665116 44564 70969 63233 7686 50 658528 539904 115003 3621 118968 118968 230076 222400 7676 53134 10 50422 2702 117724 79403 38321 354882 335277 19605 28127 6202 21925 361249 340730 20519 31336 2480 28856 TAX 318 318 MEDICAL SUPPLIES 1607299 1603822 3477 CONSULTING & COMPUTER E 325602 255982 69600 20 REPAIRS 220396 201707 18689 386287 283748 88929 13610 12960124 10464653 2430904 64567 233459 212923 2314068 4446049 457910 751825 527676 482164 11886 10950 25131 30249 7882881 2134205 4967768 5748676 1361715 1328427 1828 1694 9901441 13012957 746984 765532 556110 712642 1303094 1478174 X 7947579 10699093 650768 835690 8598347 11534783 9901441 13012957 2516072 -207117 627481 0 X X 0 1 X 1 1 1 X 2025778 3961224 3211861 4095940 5019173 18313976 2025778 3961224 3211861 4095940 5019173 18313976 18313976 31644 45973 -58447 48409 36303 103882 18417858 40558299 0.99440 0.99830 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5181057 772868 4408189 2701824 1361337 1340487 5748676 15929923 -207117 627481 33363 453727 15476196 0 15476196 12993487 33363 33363 12960124 0 12960124 PART XI, LINE 2D - OTHER ADJUSTMENTS: EXPENSES REPORTED ON SCHEDULE G 33,363. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES REPORTED ON SCHEDULE G 33,363. 5K RACE 66378 31491 34887 1200 15830 0 16332 66378 31491 34887 1200 15830 16332 33362 1525 X X 0 0 0 0 0 0 0 0 0 JULIE A ELDER OFFICER 178477 0 0 0 0 0 0 0 10918 0 189395 0 0 0 ROGER G NOLTE OFFICER 149898 0 0 0 0 0 0 0 5563 0 155461 0 0 0 DAVID SANFORD CHIEF EXECUTIVE OFFICER 158667 0 0 0 0 0 0 0 10323 0 168990 0 0 0 CHAD SANFORD SON OF CEO 48659 CHAD SANFORD IS THE SON OF DAVID SANFORD, CEO OF GRACEMED. CHAD IS AN EMPLOYEE OF GRACEMED. 0 SARA BAYLESS DAUGHTER OF OFFICER 40257 SARA BAYLESS IS THE DAUGHTER OF ROGER NOLTE, GRACEMED'S CHIEF DENTAL OFFICER. SARA BAYLESS IS AN EMPLOYEE OF GRACEMED. 0 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION HIRES AN OUTSIDE CPA TO PREPARE THE FINANCIAL STATEMENT AUDIT AND THE FORM 990 EACH YEAR. AFTER THE CPA HAS COMPLETED BOTH THE AUDIT AND FORM 990, THE CFO FOR THE ORGANIZATION AND THE CPA REVIEW THE INITIAL DRAFT OF THE RETURN TO ENSURE ITS COMPLETENESS AND ACCURACY. FOLLOWING THE REVIEW, THE FORM 990 IS COMPLETED AND THE ORGANIZATION FILES THE RETURN. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 24E UTILITIES: PROGRAM SERVICE EXPENSES 194,372. MANAGEMENT AND GENERAL EXPENSES 16,084. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 210,456. CONTINUING EDUCATION: PROGRAM SERVICE EXPENSES 65,933. MANAGEMENT AND GENERAL EXPENSES 9,340. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,273. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 5,539. MANAGEMENT AND GENERAL EXPENSES 56,093. FUNDRAISING EXPENSES 13,610. TOTAL EXPENSES 75,242. STAFF RECRUITING: PROGRAM SERVICE EXPENSES 15,312. MANAGEMENT AND GENERAL EXPENSES 2,700. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,012. DUES & SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 2,592. MANAGEMENT AND GENERAL EXPENSES 4,712. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,304. FORM 990, PART XII, LINE 2C THIS POLICY HAS NOT CHANGED SINCE THE PRIOR YEAR. FORM 990, PART XI, LINE 5 & SCH D, PART XI, LINE 2A REALIZED/UNREALIZED GAIN LOSS ON AUDIT REPORT FOOTNOTE AND THE AMOUNTS REPORTED ON FORM 990 DO NOT MATCH DUE TO THE USE OF DIFFERENT REPORTING METHODS BETWEEN THE AUDIT REPORT AND THE 990. BOTH METHODS HAVE THE NET EFFECT OF $64,924 INVESTMENT GAIN/LOSS AND THERE IS NO IMPACT ON INCOME REPORTING.