2013-04-02T10:39:50-05:00 2012-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2011-10-01 237156236 WEST SIDE COMMUNITY HEALTH SERVICES INC % ROBERT F STEELE CFO WEST 6512221816 153 CESAR CHAVEZ STREET ST PAUL MN 55107 ROBERT F STEELE 2013-01-24 true Brian D Todd 4178658701 2011 2016-02-25 16:41:14Z ROBERT F STEELE CFO 153 CESAR CHAVEZ STREET ST PAUL MN 55107 28904582 false X WWW.WESTSIDECHS.ORG X 1972 MN WEST 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. 11 11 333 22 0 0 9701958 9664315 14242630 15017338 122522 118357 0 0 24067110 24800010 178192 1099689 0 0 14700845 14888060 260 0 275 8419296 8166839 23298593 24154588 768517 645422 17709976 17943456 6041534 5652223 11668442 12291233 X WEST SIDE COMMUNITY HEALTH SERVICES' MISSION IS STRENGTHENING THE WELL-BEING OF OUR COMMUNITY THROUGH HEALTH CARE FOR ALL. false false 14903333 1099689 11215712 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 & 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. 2953819 2130677 THE 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. 2309855 1670949 THE 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. 20167007 true true false true false false false false false false true false false false false false false true false false false false false false false false false true true true true false false false false false false false false false false true false false false false true true true false false true 34 0 true 333 true false false false false false false false false false false X 11 11 false false false false false false false true true false false true true true true true true true false false MN X X ROBERT F STEELE CFO 6512221816 153 CESAR CHAVEZ ST ST PAUL MN 55107 X ROBERT SHEEHY 1.0 X X 0 0 0 SUSAN MARSCHALK 1.0 X X 0 0 0 KELLY WOODS BIRKENHOLZ 1.0 X X 0 0 0 PETE SURDO 1.0 X X 0 0 0 WILLIAM RILEY 1.0 X 0 0 0 BERENICE RIVERA 1.0 X 0 0 0 SHENG THAO 1.0 X 0 0 0 BRYAN WARREN 1.0 X 0 0 0 BILL THOMPSON 1.0 X 0 0 0 LUIS ORTEGA 1.0 X 4380 AMANDA LOGE 1.0 X 0 0 0 ROSAURA DE LA TORRE 1.0 X 0 0 0 CHRIS MISENER 1.0 X 0 0 0 JAESON T FOURNIER 40.0 X 175479 0 11294 ROBERT F STEELE 40.0 X 121764 0 4171 KATHLEEN CULHANE-PERA 32.0 X 155166 0 8266 MARY NESVIG 32.0 X 150825 0 4894 JASON COMO 40.0 X 122639 0 7941 SUSAN A BENFIELD 34.0 X 123752 0 14129 ROBERT J MCDONALD 40.0 X 131254 0 486 LYNN OGAWA 32.0 X 120275 0 9054 MARIANNE CLINTON 40.0 X 174532 0 8295 1280066 0 68530 14 false true false QUEST DIAGNOSTICS INC LABORATORY 375005 NETGAIN TECHNOLOGY INC IT HOSTING SERVICES 274445 POPE ASSOCIATES BUILDING DESIGN 305722 GE HEALTHCARE IITS USA IT LICENSING 220140 XO COMMUNICATIONS TELECOMMUNICATIONS 128721 7 432375 7812413 1419527 276592 9664315 NET PATIENT SERVICE REVENUE 624100 14687986 14687986 PROGRAM INCENTIVES 624100 253007 253007 PRECEPTING 624100 70339 70339 OTHER 624100 6006 6006 15017338 20947 20947 0 0 4201982 4104572 97410 97410 97410 0 0 0 0 24800010 15017338 118357 926861 926861 172828 172828 0 0 682320 337033 345287 0 11463293 10321990 1141303 111538 105900 5638 1669104 1474621 194483 961805 845314 116491 0 8219 8219 81971 81971 0 0 7499 7499 1370593 831328 539265 5586 2766 2820 851438 289296 561867 275 557418 212973 344445 0 1002860 680736 322124 87078 60729 26349 0 110861 60848 50013 163015 163015 0 292691 239701 52990 13968 2966 11002 BAD DEBT 547119 547119 MEDICAL SUPPLIES & DRUGS 2961589 2961589 LICENSES, DUES, SUBSCRIPTIONS 77161 69664 7497 RECRUITING & RETENTION 27773 22745 5028 24154588 20167007 3987306 275 160125 34779 7257651 4637076 1223223 1766049 889026 910790 0 0 0 0 0 4037691 100652 91759 26820 212258 8903736 2952076 6214714 5951660 1504765 0 0 0 0 0 0 0 333000 301394 17709976 17943456 1738729 1617825 0 0 98096 88592 3878600 3670890 0 0 0 0 326109 274916 0 0 0 0 6041534 5652223 X 10833149 10973122 835293 1318111 0 0 11668442 12291233 17709976 17943456 X 645422 -22631 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true false OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1(I) 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. 0 622641 622641 5975636 1230160 4745476 0 875328 735461 139867 1430131 986455 443676 0 0 0 0 5951660 24800010 24154588 645422 -22631 -22631 622791 23560089 -22631 264189 -1481479 -1239921 24800010 24800010 22937298 264189 264189 22673109 7499 1473980 1481479 24154588 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 RECONCILING ITEMS SCHEDULE D, PART XII, LINE 2D ( 926,861) CONTRIBUTION EXPENSE ( 547,119) BAD DEBT EXPENSE ( 7,499) INVESTMENT FEES ------------ (1,481,479) OTHER RECONCILING ITEMS SCHEDULE D, PART XIII, LINE 4B 926,861 CONTRIBUTION EXPENSE 547,119 BAD DEBT EXPENSE ----------- 1,473,980 true EAST SIDE HEALTH CENTER INC 153 CESAR CHAVEZ ST ST PAUL MN 55107 455562728 501(C)(3) 926861 SUPPORT 1 EVICTION PREVENTION PROGRAM-RENT 25 23009 EVICTION PREVENTION PROGRAM-UTILITIES 374 143241 EVICTION PREVENTION PROGRAM-SANITATION 27 6578 MONITORING OF GRANTS SCHEDULE I, PART I, LINE 2 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 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. X X X false false false false false false false false false JAESON T FOURNIER 175321 0 0 158 0 4536 0 6758 0 186773 0 0 0 KATHLEEN CULHANE-PERA 154691 0 0 475 0 3007 0 5259 0 163432 0 0 0 MARY NESVIG 150313 0 0 512 0 3786 0 1108 0 155719 0 0 0 MARIANNE CLINTON 173956 0 0 576 0 4036 0 4259 0 182827 0 0 0 RAMSEY COUNTY HOUSING & REDEVELOPMENT AUTHORITY 416005875 2004-04-28 5000000 BUILDING AND LAND false false false 0 0 5000000 0 0 0 100000 0 0 4900000 0 0 2004 false false true true false false false false 0.00000 0.00000 0.00000 true false true false 0 false 0 false false X X 29 270192 FMV X EYEGLASSES 1 6400 FMV 0 false false false NUMBER OF CONTRIBUTIONS SCHEDULE M, PART I, COLUMN B, LINES 20 & 25 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 27 OTHER CONTRIBUTORS, WITH EACH CONTRIBUTING LESS THAN $5,000 IN VALUE. THE ORGANIZATION ALSO RECEIVED EYEGLASSES FROM ONE CONTRIBUTOR. 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 4C 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 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 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. RELATED HOURS FORM 990, PART VII, SECTION A THE 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 ASSETS FORM 990, PART XI, LINE 5 $(22,631) UNREALIZED LOSS ON INVESTMENTS EAST SIDE HEALTH CENTER INC 153 CESAR CHAVEZ ST SAINT PAUL MN 55107 455562728 HEALTH CARE MN 501(C)(3) 3 WEST SIDE true false true false false false false false false false false false false true true false false true false EAST SIDE HEALTH CENTER INC B 926861 FMV PUBLIC CHARITY STATUS SCHEDULE R, PART II, LINE 1, COLUMN E EAST 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.