2025-11-06T08:33:59-06:00 2025-02-28 363168081 SIKICH LLC 17335 GOLF PARKWAY SUITE 500 BROOKFIELD WI 53045 990 2024-03-01 391789874 KENOSHA COMMUNITY HEALTH CENTER INC KENO 2627713560 4006 WASHINGTON RD KENOSHA WI 53144 JOHN STAMPFL CHIEF FINANCIAL OFFICER 2627643608 2025-11-05 1 0 JILL M BOYLE CPA P01246734 2627549400 2025-11-05 2024 2025-03-06 01:10:19Z MARY OUIMET 4006 WASHINGTON RD KENOSHA WI 53144 18463497 0 X WWW.KENOSHACHC.ORG X 1994 WI TO PROVIDE ACCESS TO HEALTH CARE SERVICES AND REDUCE HEALTH DISPARITIES FOR THE UNDERSERVED PEOPLE. 13 13 185 15 0 0 3628572 3196991 11613206 14917016 102869 133526 173700 129930 15518347 18377463 0 0 0 0 11438142 12765575 0 0 0 6360474 6206238 17798616 18971813 -2280269 -594350 14671666 14246441 3357218 3526343 11314448 10720098 X KENOSHA COMMUNITY HEALTH CENTER, INC.'S PURPOSE IS TO PROVIDE PRIMARY CARE AND REFERRAL HEALTH SERVICES TO DISADVANTAGED AND UNDERSERVED POPULATIONS AND PROMOTE AND ENSURE THAT BASIC PRIMARY HEALTH SERVICES ARE ACCESSIBLE TO UNINSURED AND UNDERINSURED RESIDENTS OF KENOSHA, WISCONSIN AND SURROUNDING COMMUNITIES. 0 0 5343882 6934967 DENTAL CAREINCREASE ACCESS TO COMPREHENSIVE DENTAL CARE SERVICES FOR MEDICAID ENROLLEES AND THE UNINSURED. 6060432 4988015 MEDICAL CAREINCREASE ACCESS TO COMPREHENSIVE MEDICAL CARE SERVICES FOR MEDICAID ENROLLEES AND THE UNINSURED. 2369743 3123964 BEHAVIORAL HEALTH SERVICESINCREASE ACCESS TO COMPREHENSIVE MEDICAL CARE FOR BEHAVIORAL HEALTH CARE SERVICES FOR MEDICAID ENROLLEES AND THE UNINSURED. 13774057 1 1 0 0 0 0 0 0 0 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 25 0 185 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X JOHN STAMPFL 2627713561 4006 WASHINGTON RD KENOSHA WI 53144 ANITA ROJAS-JOHNSON BOARD MEMBER & BOARD PRES 1.00 X X 0 0 0 KATE TRUDELL BOARD MEMBER & BOARD VP 1.00 X X 0 0 0 DAVID GEERTSEN BOARD MEMBER & TREASURER 1.00 X X 0 0 0 ERIN GINN BOARD MEMBER & SECRETARY 1.00 X X 0 0 0 MARIA MENDOZA BOARD MEMBER 1.00 X 0 0 0 KATHERINE EASTHON BOARD MEMBER 1.00 X 0 0 0 RONALD TATUM BOARD MEMBER 1.00 X 0 0 0 VENKATA THOTA BOARD MEMBER 1.00 X 0 0 0 STEPHEN NEUBERGER BOARD MEMBER 1.00 X 0 0 0 TONY MOORE BOARD MEMBER 1.00 X 0 0 0 VALENA COLEMAN BOARD MEMBER 1.00 X 0 0 0 JULIA ROBINSON BOARD MEMBER 1.00 X 0 0 0 MARCUS JACKSON BOARD MEMBER 1.00 X 0 0 0 MARY OUIMET CHIEF EXECUTIVE OFFICER 40.00 X 243073 0 16269 JOHN STAMPFL CHIEF FINANCIAL OFFICER 40.00 X 159258 0 0 TIMOTHY SANBORN CHIEF CLINICAL OFFICER 40.00 X 150000 0 0 BHARATHI PULLA PHYSICIAN 40.00 X 285846 0 13124 MATHEW MCCARTHY PSYCHIATRIST 40.00 X 216547 0 8563 DAVID CONNELL DENTIST 40.00 X 200374 0 6562 KENDALL WILKES DENTIST 40.00 X 186589 0 6562 JOSE VILLANUEVA DENTIST 40.00 X 178000 0 6310 1619687 0 57390 27 0 1 0 PANACEA SOLUTIONS LLC 4136 TECHNOLOGY PARKWAY SHEBOYGAN WI 53083 IT AND REVENUE CYCLE SERVICES 680168 OCHIN INC PO BOX 5426 PORTLAND OR 97728 ELECTRONIC HEALTH RECORDS 448279 CLEAN & GREEN SOLUTIONS 5008 GREEN BAY RD STE 3 KENOSHA WI 53144 JANITORIAL SERVICES 229938 CLOUDMED 5700 GRANITE PARKWAY PLANO TX 75024 340B CONSULTING SERVICES 138834 DOOLEY & ASSOCIATES 4515 WASHINGTON RD LOWER LEVEL KENOSHA WI 53144 MARKETING SERVICES 118351 9 3191514 5477 3196991 PATIENT SERVICE FEE 621110 12635892 12635892 PHARMACY REVENUE 900099 2281124 2281124 14917016 34143 34143 129930 0 129930 129930 129930 5417 180000 5417 80617 0 99383 99383 99383 18377463 15046946 0 133526 583033 37513 545520 10286812 7193642 3093170 1131152 750980 380172 764578 500303 264275 102985 23489 79496 1164149 948332 215817 138459 110436 28023 108302 70885 37417 1466826 1339957 126869 227214 225704 1510 19374 9708 9666 20441 5285 15156 59575 59575 932954 739012 193942 93917 93917 MEDICAL & LAB EXPENSE 1430163 1429416 747 EQUIPMENT 234106 211412 22694 STAFF DEVELOPMENT 118966 28123 90843 DUES & SUBSCRIPTIONS 35928 15662 20266 52879 40281 12598 18971813 13774057 5197756 0 450 450 1187353 1478266 180779 88854 1006790 1210737 197378 170681 19465095 8795265 11491126 10669830 607790 627623 14671666 14246441 1603329 1920294 18695 388 1735194 1605661 3357218 3526343 X 11314448 10720098 11314448 10720098 14671666 14246441 -594350 0 X 0 1 X 1 1 1 X 6920754 7301308 11142383 3628572 3196991 32190008 6920754 7301308 11142383 3628572 3196991 32190008 32190008 77 1474 151036 77067 34143 263797 8457 29302 25430 43207 106396 32560201 48606222 0.98860 0.98850 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2020 AMOUNT: $ 8,457. 2021 AMOUNT: $ 29,302. 2022 AMOUNT: $ 25,430. 2023 AMOUNT: $ 43,207. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 888847 888847 11418970 3999146 7419824 842220 322851 519369 4305622 3789349 516273 2009436 683919 1325517 10669830 X 18377463 0 18377463 0 18377463 18971813 0 18971813 0 18971813 PART X, LINE 2: THE CENTER IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AS OTHER THAN A PRIVATE FOUNDATION AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE LLC IS CONSIDERED A DISREGARDED ENTITY FOR INCOME TAX PURPOSES. THE ORGANIZATION FILES VARIOUS FEDERAL OR STATE NON-PROFIT TAX RETURNS. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL OR STATE EXAMINATIONS BY TAX AUTHORITIES FOR YEARS PRIOR TO 2020. X X X X 0 0 0 0 0 0 0 1 0 BHARATHI PULLA PHYSICIAN 285277 0 569 0 0 0 0 0 13124 0 298970 0 0 0 MARY OUIMET CHIEF EXECUTIVE OFFICER 243073 0 0 0 0 0 0 0 16269 0 259342 0 0 0 MATHEW MCCARTHY PSYCHIATRIST 216547 0 0 0 0 0 0 0 8563 0 225110 0 0 0 DAVID CONNELL DENTIST 176036 0 24338 0 0 0 0 0 6562 0 206936 0 0 0 KENDALL WILKES DENTIST 186568 0 21 0 0 0 0 0 6562 0 193151 0 0 0 JOSE VILLANUEVA DENTIST 178000 0 0 0 0 0 0 0 6310 0 184310 0 0 0 JOHN STAMPFL CHIEF FINANCIAL OFFICER 159258 0 0 0 0 0 0 0 0 0 159258 0 0 0 PART I, LINE 4 DURING FY 2025, KCHC PAID SEVERANCE PAYMENTS OF $37,916 TO ITS FORMER CFO AND $30,769 TO ITS FORMER CHIEF DENTAL OFFICER. SEE NEXT TAB FOR DETAILS. PART I, LINE 7 AS OF FEBRUARY 28, 2025, THE ORGANIZATION ACCRUED $184,239 UNDER ITS INCENTIVE COMPENSATION PROGRAM BASED ON MEETING GOALS FOR NUMBER OF ENCOUNTERS, CLINICAL QUALITY, PATIENT SATISFACTION AND PROFIT MARGIN. THIS AMOUNT WAS PAID IN APRIL 2025 TO 42 EMPLOYEES FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CHAIRPERSON OF THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS 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 APPROVED 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. KCHC REAL ESTATE LLC 4536 22ND AVENUE KENOSHA WI 53140 391789874 REAL ESTATE HOLDINGS WI KENOSHA COMMUNITY HEALTH CENTER INC