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WEST SIDE COMMUNITY HEALTH SERVICES INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
WEST SIDE COMMUNITY HEALTH SERVICES INC (EIN 23-7156236)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-04-02
IRS object ID
201330929349300703
Schema version
2011v1.5
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-04-02T10:39:50-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237156236EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WEST SIDE COMMUNITY HEALTH SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% ROBERT F STEELE CFOInCareOfName
Name ControlWESTNameControl
Phone6512221816Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1153 CESAR CHAVEZ STREETAddressLine1
CityST PAULCity
StateMNState
ZIP Code55107ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT F STEELEName
TitleCFOTitle
Date Signed2013-01-24DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBrian D ToddName
Phone4178658701Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROBERT F STEELE CFONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1153 CESAR CHAVEZ STREETAddressLine1
CityST PAULCity
StateMNState
ZIP Code55107ZIPCode
FieldValueIRS element (for citing)
Gross Receipts28904582GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.WESTSIDECHS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1972YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionWEST SIDE COMMUNITY HEALTH SERVICES ENVISIONS A COMMUNITY IN WHICH ALL PEOPLE HAVE ACCESS TO EXCEPTIONAL, COMPREHENSIVE HEALTH CARE & ARE LIVING HEALTHY LIVES. SEE SCHEDULE O.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees333TotalNbrEmployees
Total Nbr Volunteers22TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year9701958ContributionsGrantsPriorYear
Contributions Grants Current Year9664315ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14242630ProgramServiceRevenuePriorYear
Program Service Revenue CY15017338ProgramServiceRevenueCY
Investment Income Prior Year122522InvestmentIncomePriorYear
Investment Income Current Year118357InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year24067110TotalRevenuePriorYear
Total Revenue Current Year24800010TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year178192GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1099689GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year14700845SalariesEtcPriorYear
Salaries Etc Current Year14888060SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year260TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year275TotalFundrsngExpCurrentYear
Other Expense Prior Year8419296OtherExpensePriorYear
Other Expenses Current Year8166839OtherExpensesCurrentYear
Total Expenses Prior Year23298593TotalExpensesPriorYear
Total Expenses Current Year24154588TotalExpensesCurrentYear
Revenues Less Expenses Prior Year768517RevenuesLessExpensesPriorYear
Revenues Less Expenses CY645422RevenuesLessExpensesCY
Total Assets BOY17709976TotalAssetsBOY
Total Assets EOY17943456TotalAssetsEOY
Total Liabilities BOY6041534TotalLiabilitiesBOY
Total Liabilities EOY5652223TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY11668442NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY12291233NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionWEST SIDE COMMUNITY HEALTH SERVICES' MISSION IS STRENGTHENING THE WELL-BEING OF OUR COMMUNITY THROUGH HEALTH CARE FOR ALL.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense14903333Expense
Grants1099689Grants
Revenue11215712Revenue
DescriptionTHE 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 & WRAP-AROUND SERVICES SUCH AS CHILD CARE, TRANSPORTATION & ASSISTANCE WITH HLTH PLAN ENROLLMENT. WE ARE PROUD TO SERVE OVER 35,000 PATIENTS EACH YR. WE SERVE THE DIVERSE ST. PAUL METRO AREA COMMUNITY - PARTICULARLY THE LATINO & HMONG POPULATIONS, ST. PAUL PUBLIC HOUSING RESIDENTS, PEOPLE IN THE HOMELESS POPULATION, & ADOLESCENTS IN A SERVICE AREA THAT INCLUDES A SIGNIFICANT PORTION OF THE CITY OF ST. PAUL & RAMSEY COUNTY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2953819Expense
Revenue2130677Revenue
DescriptionTHE ORGANIZATION PROVIDES MEDICATION DISPENSING SRVCS & MEDICATION THERAPY MGMT (MTM). MTM GOES BEYOND THE STANDARD COUNSELING ASSOCIATED W/ RECEIVING A NEW PRESCRIPTION, WORKING DIRECTLY W/ DOCTORS TO ASSURE THAT ALL MEDICATION NEEDS ARE BEING MET. UNINSURED PATIENTS RECEIVE SLIDING SCALE DISCOUNTS BASED UPON INCOME & 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 MEDS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2309855Expense
Revenue1670949Revenue
DescriptionTHE ORGANIZATION PROVIDES PREVENTIVE, RESTORATIVE, & EMERGENCY DENTAL SERVICES TO OVER 5,500 PATIENTS AT TWO CLINICS: WEST SIDE DENTAL CLINIC & HELPING HAND DENTAL CLINIC. SEE SCHEDULE O FOR MORE INFORMATION.Description
FieldValueIRS element (for citing)
Total Program Service Expense20167007TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109634NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees333NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonROBERT F STEELE CFONamePerson
Telephone Number6512221816TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1153 CESAR CHAVEZ STAddressLine1
CityST PAULCity
StateMNState
ZIP Code55107ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
ROBERT SHEEHY
CHAIR1.0XX000
SUSAN MARSCHALK
VICE CHAIR1.0XX000
KELLY WOODS BIRKENHOLZ
TREASURER1.0XX000
PETE SURDO
SECRETARY1.0XX000
WILLIAM RILEY
DIRECTOR1.0X000
BERENICE RIVERA
DIRECTOR1.0X000
SHENG THAO
DIRECTOR1.0X000
BRYAN WARREN
DIRECTOR1.0X000
BILL THOMPSON
DIRECTOR1.0X000
LUIS ORTEGA
DIRECTOR1.0X4380
AMANDA LOGE
DIRECTOR THROUGH 12/20111.0X000
ROSAURA DE LA TORRE
DIRECTOR THROUGH 12/20111.0X000
CHRIS MISENER
DIRECTOR BEGINNING 1/20121.0X000
JAESON T FOURNIER
CEO40.0X175479011294
ROBERT F STEELE
CFO40.0X12176404171
KATHLEEN CULHANE-PERA
ASSOCIATE MEDICAL DIRECTOR32.015516608266X
MARY NESVIG
MEDICAL DIRECTOR32.015082504894X
JASON COMO
PHYSICIAN40.012263907941X
SUSAN A BENFIELD
PHYSICIAN34.0123752014129X
ROBERT J MCDONALD
DENTIST40.01312540486X
LYNN OGAWA
PHYSICIAN32.012027509054X
MARIANNE CLINTON
PHYSICIAN40.017453208295X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1280066TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation68530TotalOtherCompensation
Number Individuals GT100 K14NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensation
QUEST DIAGNOSTICS INC
LABORATORY375005
NETGAIN TECHNOLOGY INC
IT HOSTING SERVICES274445
POPE ASSOCIATES
BUILDING DESIGN305722
GE HEALTHCARE IITS USA
IT LICENSING220140
XO COMMUNICATIONS
TELECOMMUNICATIONS128721
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Federated Campaigns432375FederatedCampaigns
Government Grants7812413GovernmentGrants
All Other Contributions1419527AllOtherContributions
Noncash Contributions276592NoncashContributions
Total Contributions9664315TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE6241001468798614687986
PROGRAM INCENTIVES624100253007253007
PRECEPTING6241007033970339
OTHER62410060066006
FieldValueIRS element (for citing)
Total Program Service Revenue15017338TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column20947TotalRevenueColumn
Exclusion$20,947ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4201982Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities4104572Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities97410Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column97410TotalRevenueColumn
Exclusion$97,410ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column24800010TotalRevenueColumn
Related Or Exempt Function Income15017338RelatedOrExemptFunctionIncome
Exclusion$118,357ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total926861Total
Program Services926861ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total172828Total
Program Services172828ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total682320Total
Program Services337033ProgramServices
Management And General345287ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total11463293Total
Program Services10321990ProgramServices
Management And General1141303ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total111538Total
Program Services105900ProgramServices
Management And General5638ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1669104Total
Program Services1474621ProgramServices
Management And General194483ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total961805Total
Program Services845314ProgramServices
Management And General116491ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total8219Total
Management And General8219ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total81971Total
Management And General81971ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total7499Total
Management And General7499ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1370593Total
Program Services831328ProgramServices
Management And General539265ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total5586Total
Program Services2766ProgramServices
Management And General2820ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total851438Total
Program Services289296ProgramServices
Management And General561867ManagementAndGeneral
Fundraising275Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total557418Total
Program Services212973ProgramServices
Management And General344445ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1002860Total
Program Services680736ProgramServices
Management And General322124ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total87078Total
Program Services60729ProgramServices
Management And General26349ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total110861Total
Program Services60848ProgramServices
Management And General50013ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total163015Total
Management And General163015ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total292691Total
Program Services239701ProgramServices
Management And General52990ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total13968Total
Program Services2966ProgramServices
Management And General11002ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT547119547119
MEDICAL SUPPLIES & DRUGS29615892961589
LICENSES, DUES, SUBSCRIPTIONS77161696647497
RECRUITING & RETENTION27773227455028

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total24154588Total
Program Services20167007ProgramServices
Management And General3987306ManagementAndGeneral
Fundraising275Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY160125BOY
EOY34779EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7257651BOY
EOY4637076EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1223223BOY
EOY1766049EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY889026BOY
EOY910790EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY4037691EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY100652BOY
EOY91759EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY26820BOY
EOY212258EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8903736LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2952076LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6214714BOY
EOY5951660EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1504765BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY333000BOY
EOY301394EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY17709976BOY
EOY17943456EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1738729BOY
EOY1617825EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY98096BOY
EOY88592EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY3878600BOY
EOY3670890EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY326109BOY
EOY274916EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY6041534BOY
EOY5652223EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY10833149BOY
EOY10973122EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY835293BOY
EOY1318111EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11668442BOY
EOY12291233EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17709976BOY
EOY17943456EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses645422ReconcilationRevenueExpenses
Reconcilation Other Changes-22631ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierOTHER LOBBYING ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II-B, LINE 1(I)ReturnReference
ExplanationTHE 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

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis622641OtherCostOrOtherBasis
Book Value622641BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5975636OtherCostOrOtherBasis
Depreciation1230160Depreciation
Book Value4745476BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis875328OtherCostOrOtherBasis
Depreciation735461Depreciation
Book Value139867BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1430131OtherCostOrOtherBasis
Depreciation986455Depreciation
Book Value443676BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5951660TotalOfBookValueLandBuildings
Total Revenue24800010TotalRevenue
Total Expenses24154588TotalExpenses
Excess Or Deficit For Year645422ExcessOrDeficitForYear
Net Unrealized GL On Investments-22631NetUnrealizedGLOnInvestments
Total Adjustments-22631TotalAdjustments
Excess Or Deficit Per FS622791ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt23560089TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-22631NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities264189DonatedSrvcAndUseOfFacilities
Other Revenues-1481479OtherRevenues
Revenue Not Rptd F990-1239921RevenueNotRptdF990
Revenue Subtotal24800010RevenueSubtotal
Total Revenue Per Form99024800010TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt22937298TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities264189DonatedServicesUseOfFacilities
Expenses Not Rptd F990264189ExpensesNotRptdF990
Expenses Subtotal22673109ExpensesSubtotal
Investment Expenses Not Included27499InvestmentExpensesNotIncluded2
Other Expenses Not Included1473980OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1481479ExpensesNotRptdOnFinStmt
Total Expenses Per Form99024154588TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
UNCERTAIN TAX POSITIONSSCHEDULE D, PART X, LINE 2MANAGEMENT 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 RECONCILING ITEMSSCHEDULE D, PART XII, LINE 2D( 926,861) CONTRIBUTION EXPENSE ( 547,119) BAD DEBT EXPENSE ( 7,499) INVESTMENT FEES ------------ (1,481,479)
OTHER RECONCILING ITEMSSCHEDULE D, PART XIII, LINE 4B926,861 CONTRIBUTION EXPENSE 547,119 BAD DEBT EXPENSE ----------- 1,473,980

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1EAST SIDE HEALTH CENTER INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1153 CESAR CHAVEZ STAddressLine1
CityST PAULCity
StateMNState
ZIP Code55107ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient455562728EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant926861AmountOfCashGrant
Purpose Of GrantSUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII (3 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
EVICTION PREVENTION PROGRAM-RENT2523009
EVICTION PREVENTION PROGRAM-UTILITIES374143241
EVICTION PREVENTION PROGRAM-SANITATION276578

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierMONITORING OF GRANTSIdentifier
Return ReferenceSCHEDULE I, PART I, LINE 2ReturnReference
ExplanationWEST 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 2012, 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

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JAESON T FOURNIER
1753210015804536067580186773000
KATHLEEN CULHANE-PERA
1546910047503007052590163432000
MARY NESVIG
1503130051203786011080155719000
MARIANNE CLINTON
1739560057604036042590182827000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1RAMSEY COUNTY HOUSING & REDEVELOPMENT AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN416005875IssuerEIN
Date Issued2004-04-28DateIssued
Issue Price5000000IssuePrice
Description Of PurposeBUILDING AND LANDDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds5000000TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds100000IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures4900000CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2004YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty
Securities Publicly TradedSecuritiesPubliclyTraded
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions29NumberOfContributions
Noncash Contribs Rptd F990270192NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionEYEGLASSESDescription
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9906400NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierNUMBER OF CONTRIBUTIONSIdentifier
Return ReferenceSCHEDULE M, PART I, COLUMN B, LINES 20 & 25ReturnReference
ExplanationTHE 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 27 OTHER CONTRIBUTORS, WITH EACH CONTRIBUTING LESS THAN $5,000 IN VALUE. THE ORGANIZATION ALSO RECEIVED EYEGLASSES FROM ONE CONTRIBUTOR.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART I, LINE 1WEST 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 SERVICESFORM 990, PART III, LINE 4COUR 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 SERVICESFORM 990, PART III, LINE 4DADDITIONAL 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 POLICYFORM 990, PART VI, SECTION B, LINE 11BTHE 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 POLICYFORM 990, PART VI, SECTION B, LINE 12CALL 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 REVIEWFORM 990, PART VI, SECTION B, LINES 15A & 15BTHE EXECUTIVE COMMITTEE OF THE BOARD REVIEWED THE CEO COMPENSATION. THEY USED A NUMBER OF COMPENSATION SURVEYS, INCLUDING THE 2011 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 OCCURED IN DECEMBER, 2011.
DOCUMENT DISCLOSUREFORM 990, PART VI, SECTION C, LINE 19THE 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 COMPENSATIONFORM 990, PART VII, SECTION ALUIS 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.
RELATED HOURSFORM 990, PART VII, SECTION ATHE FOLLOWING INDIVIDUALS HAVE RELATED HOURS FOR THEIR SERVICE AS BOARD MEMBERS OF EAST SIDE HEALTH CENTER, INC., A RELATED PARTY. KELLY WOODS BIRKENHOLZ, BOARD MEMBER - .25 HOURS JAESON FOURNIER, CEO - 15 HOURS ROBERT STEELE, CFO - 15 HOURS
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 5$(22,631) UNREALIZED LOSS ON INVESTMENTS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1EAST SIDE HEALTH CENTER INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1153 CESAR CHAVEZ STAddressLine1
CitySAINT PAULCity
StateMNState
ZIP Code55107ZIPCode
FieldValueIRS element (for citing)
EIN455562728EIN
Primary ActivitiesHEALTH CAREPrimaryActivities
Legal Domicile StateMNLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status3PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1WEST SIDEBusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgtrueControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1EAST SIDE HEALTH CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeBTransactionType
Amount Involved926861AmountInvolved
Method Of Amt DeterminationFMVMethodOfAmtDetermination

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierPUBLIC CHARITY STATUSIdentifier
Return ReferenceSCHEDULE R, PART II, LINE 1, COLUMN EReturnReference
ExplanationEAST SIDE HEALTH CENTER, INC. IS A NEWLY FOMRED ENTITY AS OF JUNE 2012. AN APPLICATION FOR EXEMPTION IS IN PROCESS AND THUS, AS OF THE FILING OF THIS 990, A DETERMINATION LETTER HAS NOT BEEN RECEIVED IN RETURN.Explanation