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FAMILY HEALTH SERVICES INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
FAMILY HEALTH SERVICES INC (EIN 47-0548478)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-03-30
IRS object ID
201230909349300738
Schema version
2010v3.4
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)
Timestamp2012-03-30T12:07:11-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DANA F COLE & COMPANY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11248 O STREET SUITE 500AddressLine1
CityLINCOLNCity
StateNEState
ZIP Code68508ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470548478EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Family Health Services IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFAMINameControl
Phone4023352988Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 279AddressLine1
CityTecumsehCity
StateNEState
ZIP Code684500279ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSHARON RICKMANName
TitleExecutive DirectorTitle
Phone4023352988Phone
Date Signed2012-03-26DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKENT M KLUTEName
Phone4024799300Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSharon RickmanNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 279AddressLine1
CityTecumsehCity
StateNEState
ZIP Code684500279ZIPCode
FieldValueIRS element (for citing)
Gross Receipts702341GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.fhsi.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1973YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionThe Organization's purpose is to provide family planning information and services and to administer services uder the supplemental food program for women, infants and children in a nine county area in southeast Nebraska; to receive, hold and disburse funds and administer such funds exclusively for educational and charitable purposes without penuniary gain or profit, incindental or otherwise to its directors.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees25TotalNbrEmployees
Total Nbr Volunteers25TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year901906ContributionsGrantsPriorYear
Contributions Grants Current Year625607ContributionsGrantsCurrentYear
Program Service Revenue Prior Year41742ProgramServiceRevenuePriorYear
Program Service Revenue CY49875ProgramServiceRevenueCY
Investment Income Prior Year3975InvestmentIncomePriorYear
Investment Income Current Year1782InvestmentIncomeCurrentYear
Other Revenue Prior Year5469OtherRevenuePriorYear
Other Revenue Current Year25077OtherRevenueCurrentYear
Total Revenue Prior Year953092TotalRevenuePriorYear
Total Revenue Current Year702341TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year489640SalariesEtcPriorYear
Salaries Etc Current Year565851SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year275039OtherExpensePriorYear
Other Expenses Current Year273352OtherExpensesCurrentYear
Total Expenses Prior Year764679TotalExpensesPriorYear
Total Expenses Current Year839203TotalExpensesCurrentYear
Revenues Less Expenses Prior Year188413RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-136862RevenuesLessExpensesCY
Total Assets BOY512753TotalAssetsBOY
Total Assets EOY362850TotalAssetsEOY
Total Liabilities BOY70998TotalLiabilitiesBOY
Total Liabilities EOY57957TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY441755NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY304893NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe Organization's purpose is to provide family planning information and services and to administer services uder the supplemental food program for women, infants and children in a nine county area in southeast Nebraska; to receive, hold and disburse funds and administer such funds exclusively for educational and charitable purposes without penuniary gain or profit, incindental or otherwise to its directors.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense362779Expense
DescriptionSupplemental food program for women, infants and children. Grant administration and services ina nine county area in Southeast Nebraska.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense431318Expense
Revenue49875Revenue
DescriptionFamily planning services in a nine county area in Southeast Nebraska.Description
FieldValueIRS element (for citing)
Total Program Service Expense794097TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10967NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees25NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Jean BrinkmanBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4023352988TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 279AddressLine1
CityTecumsehCity
StateNEState
ZIP Code684500279ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Mike Wendt
President1.00XX000
Laurence Falk
Vice-president1.00XX000
Janelle Moran
Secretary1.00XX000
Stephanie Clark
Director1.00X000
Ted Harshbarger
Director1.00X000
Rochelle Collins
Director1.00X000
Paula Darling
Director1.00X000
Vinny Bittinger
Director1.00X000
Shirley Terry
Director1.00X000
Sharon Rickman
Executive Director40.00X6163900
Jean Brinkman
Deputy Director40.00X5317400
FieldValueIRS element (for citing)
Total Reportable Comp From Org114813TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants616405GovernmentGrants
All Other Contributions9202AllOtherContributions
Total Contributions625607TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient Fees6213002857228572
Private isurance reimb6213001878318783
Medicaid reimbursement62130025202520
FieldValueIRS element (for citing)
Total Program Service Revenue49875TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1782TotalRevenueColumn
Exclusion$1,782ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMiscellaneousDescription
Business Code900099BusinessCode
Total Revenue Column25077TotalRevenueColumn
Exclusion$25,077ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue25077TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column702341TotalRevenueColumn
Related Or Exempt Function Income49875RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$26,859ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total114813Total
Program Services103332ProgramServices
Management And General11481ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total378303Total
Program Services351951ProgramServices
Management And General26352ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total31459Total
Program Services28314ProgramServices
Management And General3145ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total41276Total
Program Services37148ProgramServices
Management And General4128ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5500Total
Program Services5500ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total910Total
Program Services910ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total26539Total
Program Services26539ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total40388Total
Program Services40388ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total58631Total
Program Services58631ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total27582Total
Program Services27582ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total30413Total
Program Services30413ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total13839Total
Program Services13839ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Contraceptives and phar2022420224
Patient care and lab fe1963119631
Telephone1292712927
Miscellaneous65066506
Staff development52025202

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total5060Total
Program Services5060ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total839203Total
Program Services794097ProgramServices
Management And General45106ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY288137BOY
EOY130794EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY56486BOY
EOY56911EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY62545BOY
EOY73040EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7015BOY
EOY3292EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY17750BOY
EOY18637EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY17463BOY
EOY8890EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis248855LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec177634LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY63304BOY
EOY71221EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY53BOY
EOY65EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY512753BOY
EOY362850EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY70998BOY
EOY57957EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY70998BOY
EOY57957EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY441755BOY
EOY304893EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY441755BOY
EOY304893EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY512753BOY
EOY362850EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-136862ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years400283CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years441228CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years671567CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year901906CurrentTaxYearMinus1Year
Current Tax Year625607CurrentTaxYear
Total3040591Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years400283CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years441228CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years671567CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year901906CurrentTaxYearMinus1Year
Current Tax Year625607CurrentTaxYear
Total3040591Total
FieldValueIRS element (for citing)
Public Support Total1703040591PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2984CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3976CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3977CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3975CurrentTaxYearMinus1Year
Current Tax Year1782CurrentTaxYear
Total16694Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2617CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4043CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5469CurrentTaxYearMinus1Year
Current Tax Year25077CurrentTaxYear
Total37217Total
FieldValueIRS element (for citing)
Total Support3094502TotalSupport
Gross Receipts From Admissions Etc252822GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.98260PublicSupportPertcentage170
Public Support Pertcent Prior Year0.95930PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis248855OtherCostOrOtherBasis
Depreciation177634Depreciation
Book Value71221BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings71221TotalOfBookValueLandBuildings
Total Revenue702341TotalRevenue
Total Expenses839203TotalExpenses
Excess Or Deficit For Year-136862ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS-136862ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt708418TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities6077DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F9906077RevenueNotRptdF990
Revenue Subtotal702341RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990702341TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt845280TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities6077DonatedServicesUseOfFacilities
Expenses Not Rptd F9906077ExpensesNotRptdF990
Expenses Subtotal839203ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990839203TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section B, line 11The 990 is reviewed by the board before filing
The conflict of interest policy is monitored by the board.Form 990, Part VI, Section B, line 12c
The compensation of the Executive Director is set by the board annually after review of the director's performance.Form 990, Part VI, Section B, line 15a
The governing documents and financial statements are available upon request.Form 990, Part VI, Section C, line 19

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationThis return is being filed between March 1, 2012, and March 30, 2012, as directed by the IRS in Notice 2012-4, because electronic filing was not available January 1, 2012 through February 29, 2012. We request that penalties be waived because it would be inequitable to impose a penalty on us due to the unusual circumstances requiring us to delay the filing of this return.Explanation