2013-02-12T17:45:02-06:00 2012-09-30 201430448 Christensen Brozek Faltys PC PO Box 1264 Norfolk NE 68702 990 2011-10-01 470833378 Norfolk Community Health Care Clinic In NORF 4026447314 110 N 16th Street Suite 16 Norfolk NE 68701 Kathleen Nordby 4026447314 2013-01-28 1 Danny Fuerhoff CPA P00026845 4023711160 2011 2016-02-25 16:41:14Z Kathleen Nordby 110 N 16th Street Suite 16 Norfolk NE 68701 2813433 0 X N/A X 1999 NE To provide access to quality primary health care and education on healthy living to all. 11 11 42 0 0 0 1339916 1436220 1360132 1374542 2785 2109 144 562 2702977 2813433 0 0 0 0 1506819 1519972 0 0 180384 1050173 976599 2556992 2496571 145985 316862 793342 1073509 166990 130294 626352 943215 To provide access to quality care and education on healthy living to all individuals in northeast Nebraska. 0 0 1727342 1375104 The organization provides medical services to the poor and uninsured or under-insured. The clinic seen patients from 18 different zip codes and had a total of 16,284 encounters/visits with a total 4,117 patients during 2011. Of this, they had 54% uninsured patients, 24% Medicaid patients, 9% Medicare patients and 13% private insurance patients. 1727342 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 42 1 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 X The Organization 4026447314 110 N 16th Street Suite 16 Norfolk NE 68701 Kathy Nordby 40.00 X 19599 68477 0 Karen Weidner 4.00 X 0 0 0 Joe Mtika 8.00 X X 0 0 0 Brenda Jones 4.00 X X 0 0 0 Doug Witte 4.00 X X 0 0 0 Pat Samuels 1.00 X 0 0 0 Betty Froehlich 1.00 X X 0 0 0 Mavis Hatcliff 1.00 X 0 0 0 Gretchen Forsell 1.00 X 0 0 0 Jeanne Reigle 1.00 X 0 0 0 Marcus Rios 1.00 X 0 0 0 Josh Moenning 1.00 X 0 0 0 19599 68477 0 0 0 0 0 0 41100 1392404 2716 1436220 Patient revenue 621110 1374542 1374542 1374542 2109 2109 Miscellaneous income 900099 562 562 562 2813433 1375104 0 2109 91240 54744 27372 9124 1198453 719072 359536 119845 29279 17567 8784 2928 106842 64105 32053 10684 94158 56495 28247 9416 6710 3355 2684 671 18851 18851 148155 111844 29693 6618 19436 3887 972 14577 74790 61455 10797 2538 57672 51905 5767 10052 4021 5026 1005 40961 20481 18432 2048 59563 29782 29781 16546 13218 2770 558 Bad debt expense 307084 307084 Dental, Medical & Pharm 107932 107932 Lab fees 77835 77835 Repairs & maintenance 14024 14024 16988 8536 8080 372 2496571 1727342 588845 180384 332702 652986 186116 175043 1200 2074 212955 65982 140948 146973 132376 96433 793342 1073509 166990 130294 166990 130294 X 591852 943215 34500 0 626352 943215 793342 1073509 X 316862 1 X X 0 1 1 X 1 1 X 90100 1194995 1289989 1339916 1436220 5351220 90100 1194995 1289989 1339916 1436220 5351220 5351220 3000 3578 2957 2785 2109 14429 2463 144 562 3169 5368818 3846891 0.99670 0.99490 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 90243 44732 45511 122712 21250 101462 146973 2813433 2496571 316862 1 1 316863 2852867 39435 39435 2813432 1 1 2813433 2536004 39435 39435 2496569 2 2 2496571 Description of Uncertain Tax Positions Under FIN 48: Part X: The Organization files required income tax returns in the U.S. federal jurisdiction. With few exceptions, the Organization is no longer subject to U.S. federal income tax examinations by tax authorities for years before 2008. The Organization has concluded no material uncertain tax positions have been taken on any open tax returns. For the current year the Organization believes all tax positions are fully supportable by existing Federal law and related interpretations and there are no uncertain tax positions to consider. Part XI, Line 8 - Other Adjustments: Rounding 1. Part XII, Line 4b - Other Adjustments: Rounding 1. Part XIII, Line 4b - Other Adjustments: Rounding 2. Form 990, Part VI, Section B, line 11 A copy of the Form 990 is provided to the board for review before it is filed. Form 990, Part VI, Section B, line 12c Any conflicts of interest are discussed among the board. A conflict of interest form must be completed and signed by each board member annually. Form 990, Part VI, Section B, line 15 There is a study to compare pay from like organizations accros the nation and midwest. Form 990, Part VI, Section C, line 19 The Organization's governing documents are made available to the public upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Rounding 1. Total to Form 990, Part XI, Line 5: 1. Form 990, Part XI, Line 2c This process has not changed from the prior year.