WEST SIDE COMMUNITY HEALTH SERVICES INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- WEST SIDE COMMUNITY HEALTH SERVICES INC (EIN 23-7156236)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-05-12
- IRS object ID
- 201421329349302057
- Schema version
- 2012v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-12T14:52:03-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 658062523 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237156236 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST SIDE COMMUNITY HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % LORI DOEHNE CFO | InCareOfName |
| Name Control | WEST | NameControl |
| Phone | 6512221816 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 153 CESAR CHAVEZ STREET | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | ST PAUL | City |
| State | MN | State |
| ZIP Code | 55107 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LORI DOEHNE | Name |
| Title | CFO | Title |
| Phone | 6512221816 | Phone |
| Date Signed | 2014-03-20 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Brian D Todd | Name |
| Phone | 4178658701 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LORI DOEHNE CFO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 153 CESAR CHAVEZ STREET | AddressLine1 |
| City | ST PAUL | City |
| State | MN | State |
| ZIP Code | 55107 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 27444685 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.WESTSIDECHS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1972 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | WEST SIDE COMMUNITY HEALTH SERVICES IS THE LEADER IN DELIVERING AFFORDABLE HEALTH CARE BY BEING THE PROVIDER OF CHOICE, DRIVEN BY COMPASSION AND RESPECT FOR ALL. SEE SCHEDULE O FOR MORE INFORMATION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 334 | TotalNbrEmployees |
| Total Nbr Volunteers | 30 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 9664315 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 11697274 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 15017338 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 15684878 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 118357 | InvestmentIncomePriorYear |
| Investment Income Current Year | 62533 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 24800010 | TotalRevenuePriorYear |
| Total Revenue Current Year | 27444685 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1099689 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 4525820 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 14888060 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 14736516 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 8166839 | OtherExpensePriorYear |
| Other Expenses Current Year | 9310135 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 24154588 | TotalExpensesPriorYear |
| Total Expenses Current Year | 28572471 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 645422 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1127786 | RevenuesLessExpensesCY |
| Total Assets BOY | 17943456 | TotalAssetsBOY |
| Total Assets EOY | 21312908 | TotalAssetsEOY |
| Total Liabilities BOY | 5652223 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10149461 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 12291233 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 11163447 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | WEST SIDE COMMUNITY HEALTH SERVICES' MISSION IS STRENGTHENING THE WELL-BEING OF OUR COMMUNITY THROUGH HEALTH CARE FOR ALL. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 17103976 | Expense |
| Grants | 4525820 | Grants |
| Revenue | 11053662 | Revenue |
| Description | THE ORGANIZATION PROVIDES COMPREHENSIVE HEALTH CARE & SOCIAL SERVICES WITH BILINGUAL/BICULTURAL STAFF ON A SLIDING FEE SCALE. SERVICES INCLUDE PRIMARY, SPECIALTY, PREVENTIVE, URGENT CARE, COMPLEMENTARY, PHARMACY, DENTAL, OB/GYN, MENTAL HEALTH, SOCIAL AND WRAP-AROUND SERVICES SUCH AS CHILD CARE, TRANSPORTATION AND ASSISTANCE WITH HEALTH PLAN ENROLLMENT. WE ARE PROUD TO SERVE OVER 35,000 PATIENTS EACH YEAR. WE SERVE THE DIVERSE ST. PAUL METRO AREA COMMUNITY - PARTICULARLY THE LATINO AND HMONG POPULATIONS, ST. PAUL PUBLIC HOUSING RESIDENTS, PEOPLE IN THE HOMELESS POPULATION, AND ADOLESCENTS IN A SERVICE AREA THAT INCLUDES A SIGNIFICANT PORTION OF THE CITY OF ST. PAUL AND RAMSEY COUNTY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3097648 | Expense |
| Revenue | 2946633 | Revenue |
| Description | THE ORGANIZATION PROVIDES MEDICATION DISPENSING SERVICES AND MEDICATION THERAPY MANAGEMENT (MTM). MTM GOES BEYOND THE STANDARD COUNSELING ASSOCIATED WITH RECEIVING A NEW PRESCRIPTION, WORKING DIRECTLY WITH DOCTORS TO ASSURE THAT ALL MEDICATION NEEDS ARE BEING MET. UNINSURED PATIENTS RECEIVE SLIDING SCALE DISCOUNTS BASED UPON INCOME AND LOWER PRICED DRUGS. WHEN PRICES STILL REMAIN TOO HIGH, PHARMACISTS AID PATIENTS IN RECEIVING MEDICATION THROUGH MANUFACTURER PATIENT ASSISTANCE PROGRAMS, WHICH PROVIDES FREE MEDICATION TO QUALIFYING UNINSURED PATIENTS, OR THROUGH THE DISPENSING OF SAMPLE MEDICATION. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4076554 | Expense |
| Revenue | 1684583 | Revenue |
| Description | THE ORGANIZATION PROVIDES PREVENTIVE, RESTORATIVE, AND EMERGENCY DENTAL SERVICES TO OVER 5,500 PATIENTS AT TWO CLINICS: WEST SIDE DENTAL CLINIC AND HELPING HAND DENTAL CLINIC. SEE SCHEDULE O FOR MORE INFORMATION. THE ORGANIZATION PROVIDES PREVENTIVE, RESTORATIVE, AND EMERGENCY DENTAL SERVICES TO OVER 5,500 PATIENTS AT TWO CLINICS: WEST SIDE DENTAL CLINIC AND HELPING HAND DENTAL CLINIC. SEE SCHEDULE O FOR MORE INFORMATION. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 24278178 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | true | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 34 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 334 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LORI DOEHNE CFO | NamePerson |
| Telephone Number | 6512221816 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 153 CESAR CHAVEZ ST | AddressLine1 |
| City | ST PAUL | City |
| State | MN | State |
| ZIP Code | 55107 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| ROBERT SHEEHY | |||||||||
| SECRETARY | 1.0 | 0.0 | X | X | 0 | 0 | 0 | ||
| SUSAN MARSCHALK | |||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| KELLY WOODS BIRKENHOLZ | |||||||||
| DIRECTOR ENDING 3/2013 | 1.0 | 0.25 | X | 0 | 0 | 0 | |||
| PETE SURDO | |||||||||
| CHAIR | 1.0 | 0.0 | X | X | 0 | 0 | 0 | ||
| WILLIAM RILEY | |||||||||
| DIRECTOR ENDING 4/2013 | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| BERENICE RIVERA | |||||||||
| VICE CHAIR | 1.0 | 0.0 | X | X | 0 | 0 | 0 | ||
| SHENG THAO | |||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| BRYAN WARREN | |||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| BILL THOMPSON | |||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| LUIS ORTEGA | |||||||||
| DIRECTOR ENDING 12/2012 | 1.0 | 0.0 | X | 6577 | 0 | 0 | |||
| CHRIS MISENER | |||||||||
| DIRECTOR ENDING 10/2012 | 1.0 | 0.0 | X | 0 | 0 | 0 | |||
| ANDREATTE CALIGUIRE | |||||||||
| DIRECTOR BEGINNING 6/2013 | 1.0 | 0.0 | X | ||||||
| ANDREA CARO | |||||||||
| DIRECTOR BEGINNING 8/2013 | 1.0 | 0.0 | X | ||||||
| CANDACE DAHL | |||||||||
| DIRECTOR BEGINNING 5/2013 | 1.0 | 0.0 | X | ||||||
| HLEE LEE | |||||||||
| DIRECTOR BEGINNING 1/2013 | 1.0 | 0.0 | X | ||||||
| DAWN KSEPKA | |||||||||
| TREASURER BEGINNING 11/2012 | 1.0 | 0.0 | X | X | |||||
| MARSHA CRESSY | |||||||||
| DIRECTOR BEGINNING 4/2013 | 1.0 | 0.0 | X | ||||||
| JAESON T FOURNIER | |||||||||
| CEO | 40.0 | 15.0 | X | 183511 | 0 | 11511 | |||
| ROBERT F STEELE | |||||||||
| CFO ENDING 5/2013 | 40.0 | 15.0 | X | 129219 | 0 | 5585 | |||
| LORI DOEHNE | |||||||||
| CFO BEGINNING 6/2013 | 40.0 | 0.0 | X | 0 | 0 | 0 | |||
| MARY NESVIG | |||||||||
| MEDICAL DIRECTOR | 32.0 | 0.0 | 153581 | 0 | 6071 | X | |||
| KATHLEEN CULHANE-PERA | |||||||||
| ASSOCIATE MEDICAL DIRECTOR | 32.0 | 0.0 | 132852 | 0 | 7634 | X | |||
| MUAJ LO | |||||||||
| PHYSICIAN | 40.0 | 0.0 | 153705 | 0 | 16440 | X | |||
| ROBERT MCDONALD | |||||||||
| DENTIST | 40.0 | 0.0 | 144770 | 0 | 0 | X | |||
| BRAD J MCDONNELL | |||||||||
| DENTAL DIRECTOR | 34.0 | 0.0 | 138254 | 0 | 5811 | X | |||
| SUSAN A BENFIELD | |||||||||
| PHYSICIAN | 28.0 | 0.0 | 130537 | 0 | 10459 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1173006 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 63511 | TotalOtherCompensation |
| Number Individuals GT100 K | 14 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| QUEST DIAGNOSTICS INC | |
| LABORATORY | 367345 |
| NETGAIN TECHNOLOGY INC | |
| IT HOSTING SERVICES | 357393 |
| GE HEALTHCARE IITS USA | |
| IT LICENSING | 168829 |
| REGENTS OF UNIVERSITY OF MN | |
| MEDICAL SERVICES | 132636 |
| MANAGED SERVICES INC | |
| MAINTENANCE | 130846 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Government Grants | 11089782 | GovernmentGrants |
| All Other Contributions | 607492 | AllOtherContributions |
| Noncash Contributions | 242193 | NoncashContributions |
| Total Contributions | 11697274 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | 14630670 | 14630670 |
| EHR INCENTIVE REVENUE | 624100 | 828750 | 828750 |
| PROGRAM INCENTIVES | 624100 | 172805 | 172805 |
| PRECEPTING | 624100 | 46700 | 46700 |
| OTHER | 624100 | 5953 | 5953 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 15684878 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 62533 | TotalRevenueColumn |
| Exclusion | $62,533 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 27444685 | TotalRevenueColumn |
| Related Or Exempt Function Income | 15684878 | RelatedOrExemptFunctionIncome |
| Exclusion | $62,533 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4410000 | Total |
| Program Services | 4410000 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115820 | Total |
| Program Services | 115820 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 527390 | Total |
| Program Services | 179740 | ProgramServices |
| Management And General | 347650 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11414448 | Total |
| Program Services | 10150012 | ProgramServices |
| Management And General | 1264436 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 117602 | Total |
| Program Services | 117421 | ProgramServices |
| Management And General | 181 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1809409 | Total |
| Program Services | 1574534 | ProgramServices |
| Management And General | 234875 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 867667 | Total |
| Program Services | 752106 | ProgramServices |
| Management And General | 115561 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 162822 | Total |
| Management And General | 162822 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 99253 | Total |
| Management And General | 99253 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1349138 | Total |
| Program Services | 967470 | ProgramServices |
| Management And General | 381668 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2744 | Total |
| Program Services | 1865 | ProgramServices |
| Management And General | 879 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 817370 | Total |
| Program Services | 259844 | ProgramServices |
| Management And General | 557526 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 670378 | Total |
| Program Services | 249687 | ProgramServices |
| Management And General | 420691 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1129902 | Total |
| Program Services | 724849 | ProgramServices |
| Management And General | 405053 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61023 | Total |
| Program Services | 37829 | ProgramServices |
| Management And General | 23194 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 112959 | Total |
| Program Services | 61019 | ProgramServices |
| Management And General | 51940 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151279 | Total |
| Management And General | 151279 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 269048 | Total |
| Program Services | 215785 | ProgramServices |
| Management And General | 53263 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12878 | Total |
| Program Services | 1859 | ProgramServices |
| Management And General | 11019 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | 2961470 | 2961470 | |
| BAD DEBT | 1389425 | 1389425 | |
| LICENSES, DUES, SUBSCRIPTIONS | 103684 | 93999 | 9685 |
| RECRUITING & RETENTION | 16762 | 13444 | 3318 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28572471 | Total |
| Program Services | 24278178 | ProgramServices |
| Management And General | 4294293 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34779 | BOY |
| EOY | 3670388 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4637076 | BOY |
| EOY | 5882779 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1766049 | BOY |
| EOY | 517619 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 910790 | BOY |
| EOY | 990159 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4037691 | BOY |
| EOY | 4037691 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91759 | BOY |
| EOY | 77902 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 212258 | BOY |
| EOY | 112211 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 9016217 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3221125 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5951660 | BOY |
| EOY | 5795092 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 301394 | BOY |
| EOY | 229067 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17943456 | BOY |
| EOY | 21312908 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1617825 | BOY |
| EOY | 1974144 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88592 | BOY |
| EOY | 120416 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3670890 | BOY |
| EOY | 3454839 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 274916 | BOY |
| EOY | 240201 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 4359861 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5652223 | BOY |
| EOY | 10149461 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10973122 | BOY |
| EOY | 10762991 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1318111 | BOY |
| EOY | 400456 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12291233 | BOY |
| EOY | 11163447 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17943456 | BOY |
| EOY | 21312908 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1127786 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER LOBBYING ACTIVITIES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1(I) | ReturnReference |
| Explanation | THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) AND THE MINNESOTA ASSOCIATION OF COMMUNITY HEALTH CENTERS. A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 632640 | OtherCostOrOtherBasis |
| Book Value | 632640 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5981936 | OtherCostOrOtherBasis |
| Depreciation | 1387212 | Depreciation |
| Book Value | 4594724 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 875328 | OtherCostOrOtherBasis |
| Depreciation | 755688 | Depreciation |
| Book Value | 119640 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1432068 | OtherCostOrOtherBasis |
| Depreciation | 1078225 | Depreciation |
| Book Value | 353843 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 94245 | OtherCostOrOtherBasis |
| Book Value | 94245 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5795092 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO RELATED PARTY | Description |
| Amount | $4,359,861 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4359861 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 21900237 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 254977 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | -5799425 | OtherRevenues |
| Revenue Not Rptd F990 | -5544448 | RevenueNotRptdF990 |
| Revenue Subtotal | 27444685 | RevenueSubtotal |
| Total Revenue Per Form990 | 27444685 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 23028023 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 254977 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 254977 | ExpensesNotRptdF990 |
| Expenses Subtotal | 22773046 | ExpensesSubtotal |
| Other Expenses Not Included | 5799425 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 5799425 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 28572471 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| UNCERTAIN TAX POSITIONS | SCHEDULE D, PART X, LINE 2 | 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. |
| OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12 | SCHEDULE D, PART XI, LINE 2D | $(1,389,425) BAD DEBT (4,410,000) CONTRIBUTION EXPENSE ---------- $(5,799,425) TOTAL |
| OTHER EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1 | SCHEDULE D, PART XII, LINE 4B | $ 1,389,425 BAD DEBT 4,410,000 CONTRIBUTION EXPENSE ---------- $ 5,799,425 TOTAL |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST SIDE HEALTH CENTER INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 153 CESAR CHAVEZ ST | AddressLine1 |
| City | ST PAUL | City |
| State | MN | State |
| ZIP Code | 55107 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 455562728 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 4410000 | AmountOfCashGrant |
| Purpose Of Grant | SUPPORT | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part III Form990ScheduleIPartIII (3 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant |
|---|---|---|
| EVICTION PREVENTION PROGRAM-RENT | 235 | 88909 |
| EVICTION PREVENTION PROGRAM-UTILITIES | 36 | 18181 |
| EVICTION PREVENTION PROGRAM-SANITATION | 25 | 7428 |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | MONITORING OF GRANTS | Identifier |
| Return Reference | SCHEDULE I, PART I, LINE 2 | ReturnReference |
| Explanation | WEST SIDE COMMUNITY HEALTH SERVICES OFFERS EVICTION PREVENTION SERVICES TO THOSE IN NEED IN THEIR COMMUNITY. IN ORDER TO GAIN ASSISTANCE, APPLICANTS SUBMIT A REQUEST STATING THEIR NEED. REQUESTS ARE VERIFIED WITH THE APPROPRIATE AGENCIES (IE: UTILITIES COMPANY) TO DETERMINE ACCOUNT STATUS. IF THE APPROVED APPLICANT IS ELIGIBLE FOR ASSISTANCE FROM LARGER PROGRAMS BUT NEEDS ADDITIONAL FUNDS TO PAY THE BILL OR IF THEY ARE NOT ELIGIBLE FOR THOSE PROGRAMS, WEST SIDE COMMUNITY HEALTH SERVICES WILL ASSIST IN RESOLVING THE BILL. ALL PAYMENTS ARE MADE DIRECTLY TO THE LANDLORD, UTILITY COMPANY, OR SANITATION COMPANY. CHECKS ARE PROCESSED BY WSCHS WITH SPECIFIC NAMES AND ACCOUNT NUMBERS. THIS INFORMATION GOES TO THE UTILITIES AND HC STAFF TO VERIFY AND RECORD. IN FISCAL YEAR 2013, THE ORGANIZATION PROVIDED A CONTRIBUTION TO EAST SIDE HEALTH CENTER, A RELATED PARTY. THE ORGANIZATION IS ABLE TO MONITOR THE USAGE OF THE GRANT MONEY THROUGH THIS RELATIONSHIP. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAESON T FOURNIER | ||||||||||||||
| CEO | 183343 | 0 | 0 | 0 | 168 | 0 | 4753 | 0 | 6758 | 0 | 195022 | 0 | 0 | 0 |
| MARY NESVIG | ||||||||||||||
| MEDICAL DIRECTOR | 153050 | 0 | 0 | 0 | 531 | 0 | 3854 | 0 | 2217 | 0 | 159652 | 0 | 0 | 0 |
| MUAJ LO | ||||||||||||||
| PHYSICIAN | 153573 | 0 | 0 | 0 | 132 | 0 | 0 | 0 | 16440 | 0 | 170145 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RAMSEY COUNTY HOUSING & REDEVELOPMENT AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 416005875 | IssuerEIN |
| Date Issued | 2004-04-28 | DateIssued |
| Issue Price | 5000000 | IssuePrice |
| Description Of Purpose | BUILDING AND LAND | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 0 | AmountRetired |
| Amount Bond Defeased | 0 | AmountBondDefeased |
| Total Proceeds | 5000000 | TotalProceeds |
| Amount In Reserve Fund | 0 | AmountInReserveFund |
| Capitalized Interest | 0 | CapitalizedInterest |
| Refunding Escrow | 0 | RefundingEscrow |
| Issuance Costs From Proceeds | 100000 | IssuanceCostsFromProceeds |
| Credit Enhancement | 0 | CreditEnhancement |
| Working Capital Expenditures | 0 | WorkingCapitalExpenditures |
| Capital Expenditures | 4900000 | CapitalExpenditures |
| Other Spent Proceeds | 0 | OtherSpentProceeds |
| Amount Unspent | 0 | AmountUnspent |
| Year Of Subst Completion | 2004 | YearOfSubstCompletion |
| Current Refunding | false | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | false | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | false | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0 | PrcntgePrvtBusinessUseByOthers |
| Bond Iss Meet Prvt Security Pay Test | false | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedProp |
| Remedial Action Taken | false | RemedialActionTaken |
| Non Qualified Bond Remed Procdrs | true | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiled |
| Exception To Rebate | true | ExceptionToRebate |
| Variable Rate Issue | true | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
Name Of GIC Provider NameOfGICProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | true | ProcToUndertkCorrectiveAction |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 2800 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Historical Treasures | ArtHistoricalTreasures | |
| Art Fractional Interest | ArtFractionalInterest | |
| Books And Publications | BooksAndPublications | |
| Clothing And Household Goods | ClothingAndHouseholdGoods | |
| Cars And Other Vehicles | CarsAndOtherVehicles | |
| Boats And Planes | BoatsAndPlanes | |
| Intellectual Property | IntellectualProperty | |
| Securities Publicly Traded | SecuritiesPubliclyTraded | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStock | |
| Securities Prtnrshp Trust Intrsts | SecuritiesPrtnrshpTrustIntrsts | |
| Securities Miscellaneous | SecuritiesMiscellaneous | |
| Qualified Contrib Hist Struct | QualifiedContribHistStruct | |
| Qualified Contrib Other | QualifiedContribOther | |
| Real Estate Residential | RealEstateResidential | |
| Real Estate Commercial | RealEstateCommercial | |
| Real Estate Other | RealEstateOther | |
| Collectibles | Collectibles | |
| Food Inventory | FoodInventory |
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 39 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 239393 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | Taxidermy | |
| Historical Artifacts | HistoricalArtifacts | |
| Scientific Specimens | ScientificSpecimens | |
| Archaeological Artifacts | ArchaeologicalArtifacts | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | NUMBER OF CONTRIBUTIONS | Identifier |
| Return Reference | SCHEDULE M, PART I, COLUMN B, LINES 1 & 20 | ReturnReference |
| Explanation | THE ORGANIZATION RECEIVED DONATIONS OF DRUGS AND MEDICAL SUPPLIES OVER $5,000 IN VALUE FROM TWO ENTITIES. ADDITIONALLY, THE ORGANIZATION RECEIVED DONATIONS OF DRUGS AND MEDICAL SUPPLIES FROM 37 OTHER CONTRIBUTORS, WITH EACH CONTRIBUTING LESS THAN $5,000 IN VALUE. THE ORGANIZATION ALSO RECEIVED WORKS OF ART FROM ONE CONTRIBUTOR. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART I, LINE 1 | WEST SIDE COMMUNITY HEALTH SERVICES IS THE LEADER IN DELIVERING AFFORDABLE HEALTH CARE BY BEING THE PROVIDER OF CHOICE, DRIVEN BY COMPASSION AND RESPECT FOR ALL. |
| PROGRAM SERVICES | FORM 990, PART III, LINE 4B | OUR BRIGHT SMILES DENTAL PROGRAM IS A PARTNERSHIP WITH THE GREATER TWIN CITIES UNITED WAY & THE KNIGHT FOUNDATION. SERVICES ARE PROVIDED FOR CHILDREN IN RAMSEY & DAKOTA COUNTIES. THE PARTNERSHIP FOR IMPROVING CHILDREN'S ORAL HEALTH IN RAMSEY COUNTY STRIVES TO IMPROVE THE ORAL HEALTH OF DISADVANTAGED POPULATIONS THROUGH COMMUNITY OUTREACH, EDUCATION, & DENTAL SERVICES. BRIGHT SMILES STRIVES TO ENSURE THAT LATINO CHILDREN HAVE ACCESS TO DENTAL CARE & FAMILIES ARE EDUCATED ON EFFECTIVE ORAL HEALTH PRACTICES. THERE IS NO CHARGE FOR THESE SERVICES. |
| OTHER PROGRAM SERVICES | FORM 990, PART III, LINE 4D | ADDITIONAL PROGRAM SERVICES THE ORGANIZATION PROVIDES AT ITS CLINICS INCLUDE: -ADOLESCENT HEALTH CARE SERVICES -DIABETES CARE -EVICTION PREVENTION -FAMILY PLANNING & PREGNANCY TESTING -FAMILY SUPPORT & MENTAL HEALTH COUNSELING -HEALTH EDUCATION -HIV CARE -NUTRITION SERVICES -PRENATAL CARE -SENIOR HEALTHCARE -WELL CHILD CARE AND IMMUNIZATIONS -WOMEN'S HEALTH, AND -WOMEN, INFANTS AND CHILDREN (WIC) PROGRAM |
| 990 REVIEW POLICY | FORM 990, PART VI, SECTION B, LINE 11B | THE RETURN IS PREPARED BY AN INDEPENDENT ACCOUNTANT USING THE AUDITED FINANCIAL RECORDS OF THE ORGANIZATION. THEN, THE CEO, CFO, FINANCE COMMITTEE, AND BOARD OF DIRECTORS REVIEW AND APPROVE THE RETURN PRIOR TO BEING FILED. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS ARE EXPECTED TO EXERCISE INDEPENDENT JUDGMENT IN OVERSEEING THE BUSINESS AFFAIRS OF THE ORGANIZATION. BOARD MEMBERS ARE PROHIBITED FROM ENGAGING IN ANY SITUATION THAT IS OR APPEARS TO BE A CONFLICT OF INTEREST. THIS INCLUDES PROHIBITING BOARD MEMBERS AND MEMBERS OF THEIR IMMEDIATE FAMILY FROM BEING EMPLOYEES OR CONTRACTORS OF WEST SIDE COMMUNITY HEALTH SERVICES. ON AN ANNUAL BASIS, ALL BOARD OF DIRECTORS AND COMMITTEE MEMBERS MUST SIGN A WRITTEN DECLARATION OF THE FOLLOWING: 1. FIT OF ORGANIZATIONAL MISSION WITH PERSONAL GOALS. 2. INDIVIDUAL OR IMMEDIATE FAMILY PARTICIPATION IN OTHER BUSINESS RELATIONSHIPS OR THE ENGAGEMENT OF OTHER OUTSIDE ACTIVITIES THAT MAY IMPAIR INDEPENDENCE OF JUDGMENT CONCERNING THE OPERATIONS OF WEST SIDE COMMUNITY HEALTH SERVICES. 3. INDIVIDUAL OR IMMEDIATE FAMILY PERSONAL FINANCIAL INTERESTS THAT MAY IMPAIR INDEPENDENCE OF JUDGMENT OR INFLUENCE DECISIONS OR ACTIONS CONCERNING WEST SIDE COMMUNITY HEALTH SERVICES. 4. INDIVIDUAL OR IMMEDIATE FAMILY INVOLVEMENT, OR OTHER BOARD OR OFFICER INVOLVEMENT, IN ANY BUSINESS TRANSACTIONS INVOLVING MATERIAL INTEREST, DIRECT OR INDIRECT, PENDING OR COMPLETED, TO WHICH WEST SIDE COMMUNITY HEALTH SERVICES WAS OR IS TO BE A PARTY. 5. INDIVIDUAL OR IMMEDIATE FAMILY INVOLVEMENT OR OTHER BOARD OR OFFICER INVOLVEMENT, IN ANY BUSINESS TRANSACTION WITH A COMPANY WHICH SUBSTANTIALLY COMPETES WITH WEST SIDE COMMUNITY HEALTH SERVICES. 6. SIGNED STATEMENTS WILL BE KEPT ON FILE. ANY DECLARATION NOTING A POTENTIAL CONFLICT OF INTEREST WILL BE FURTHER REVIEWED BY THE EXECUTIVE COMMITTEE. |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINES 15A & 15B | THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWED THE CEO COMPENSATION. THEY USED A NUMBER OF COMPENSATION SURVEYS, INCLUDING THE 2012 NACHC AND SURVEYS FROM THE WOOD EXECUTIVE SEARCH FIRM. THE EXECUTIVE COMMITTEE RECOMMENDED THE COMPENSATION STRUCTURE TO THE FULL BOARD FOR APPROVAL. ALL OTHER OFFICERS AND KEY EMPLOYEE SALARIES ARE REVIEWED AND APPROVED BY THE CEO ON AN ANNUAL BASIS. A REVIEW LAST OCCURRED IN DECEMBER 2012. |
| DOCUMENT DISCLOSURE | FORM 990, PART VI, SECTION C, LINE 19 | THE AUDIT REPORT AND FORM 990 ARE CURRENTLY AVAILABLE TO THE PUBLIC FOR VIEWING ON THE ORGANIZATION'S WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AND WILL BE MAILED TO THE REQUESTOR WHEN ANY INQUIRY IS RECEIVED BY THE ORGANIZATION. |
| DIRECTOR COMPENSATION | FORM 990, PART VII, SECTION A | LUIS ORTEGA RECEIVED COMPENSATION FROM THE ORGANIZATION, WHICH WAS PROVIDED FOR HIS PARTICIPATION, AS A COMMUNITY MEMBER, IN A RESEARCH PROJECT. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR ROLES AS DIRECTORS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST SIDE HEALTH CENTER INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 153 CESAR CHAVEZ ST | AddressLine1 |
| City | SAINT PAUL | City |
| State | MN | State |
| ZIP Code | 55107 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 455562728 | EIN |
| Primary Activities | RE HOLDING | PrimaryActivities |
| Legal Domicile State | MN | LegalDomicileState |
| Exempt Code Section | 501(C)3 | ExemptCodeSection |
| Public Charity Status | 11A II | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST SIDE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | true | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| EAST SIDE HEALTH CENTER INC | ||
| B | 4410000 | FMV |
| EAST SIDE HEALTH CENTER INC | ||
| E | 4359861 | FMV |
| EAST SIDE HEALTH CENTER INC | ||
| K | 133336 | FMV |