STRATEGY STUDIO / PUBLIC DATA EXPLORER

COMBINED HEALTH AGENCIES DRIVE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COMBINED HEALTH AGENCIES DRIVE INC (EIN 23-7162972)
Tax period
2011-07-01 to 2012-06-30
Filed
2012-11-09
IRS object ID
201233149349301043
Schema version
2011v1.2
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)
Timestamp2012-11-09T11:58:56-06:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN476097913EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SEIM JOHNSON LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line118081 BURT STREET SUITE 200AddressLine1
CityOMAHACity
StateNEState
ZIP Code680224722ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237162972EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COMBINED HEALTH AGENCIES DRIVEBusinessNameLine1
Business Name Line2COMMUNITY HEALTH CHARITIES NEBRASKABusinessNameLine2
FieldValueIRS element (for citing)
Name ControlCOMBNameControl
Phone4026148500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1212 SOUTH 74TH STREET NO 205AddressLine1
CityOMAHACity
StateNEState
ZIP Code68114ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHELLE GROSSMANName
TitlePRESIDENT/CEOTitle
Phone4026148500Phone
Date Signed2012-11-07DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJULIE M GERKENName
PTINP00400882PTIN
Phone4023302660Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMICHELLE GROSSMANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1212 SOUTH 74TH STREET NO 205AddressLine1
CityOMAHACity
StateNEState
ZIP Code68114ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2747641GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number3071GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.CHCNE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1971YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionIMPROVING LIVES BY RAISING FUNDS FOR NEBRASKA'S HEALTH CHARITIESActivityOrMissionDescription
Nbr Voting Members Governing Body48NbrVotingMembersGoverningBody
Nbr Independent Voting Members48NbrIndependentVotingMembers
Total Nbr Employees9TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2533334ContributionsGrantsPriorYear
Contributions Grants Current Year2732783ContributionsGrantsCurrentYear
Program Service Revenue Prior Year18354ProgramServiceRevenuePriorYear
Program Service Revenue CY14855ProgramServiceRevenueCY
Investment Income Prior Year6106InvestmentIncomePriorYear
Investment Income Current Year3InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year2557794TotalRevenuePriorYear
Total Revenue Current Year2747641TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2034095GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2228555GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year369817SalariesEtcPriorYear
Salaries Etc Current Year365381SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year46966TotalFundrsngExpCurrentYear
Other Expense Prior Year140711OtherExpensePriorYear
Other Expenses Current Year142877OtherExpensesCurrentYear
Total Expenses Prior Year2544623TotalExpensesPriorYear
Total Expenses Current Year2736813TotalExpensesCurrentYear
Revenues Less Expenses Prior Year13171RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10828RevenuesLessExpensesCY
Total Assets BOY1866384TotalAssetsBOY
Total Assets EOY1888894TotalAssetsEOY
Total Liabilities BOY1573025TotalLiabilitiesBOY
Total Liabilities EOY1581195TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY293359NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY307699NetAssetsOrFundBalancesEOY
Mission DescriptionIMPROVING LIVES BY RAISING FUNDS FOR NEBRASKA'S HEALTH CHARITIESMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2590616Expense
Grants2228555Grants
Revenue14855Revenue
DescriptionCHC-NE CONNECTS EMPLOYEES AND EMPLOYERS VIA THE WORKPLACE TO CHC'S MEMBER CHARITIES AND THEIR PROGRAMS, SERVICES AND VOLUNTEER OPPORTUNITIES. IT IS THROUGH THIS RELATIONSHIP THAT EMPLOYEES AND EMPLOYERS HAVE THIS OPPORTUNITY TO GIVE BACK TO THE CHC-NE MEMBER AGENCIES THROUGH PAYROLL DEDUCTION.Description
Total Program Service Expense2590616TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
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 Organizations1GrantsToOrganizations
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 With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees9NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members48NbrVotingGoverningBodyMembers
Number Independent Voting Members48NumberIndependentVotingMembers
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
Own WebsiteXOwnWebsite
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonWENDY OHLNamePerson
Telephone Number4026148500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1212 S 74TH STREETAddressLine1
CityOMAHACity
StateNEState
ZIP Code68114ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (50 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationInstitutional TrusteeInstitutionalTrustee
ROB REED JR
STATE BOARD CHAIR1.00XX000
LEONARD SOMMER
BOARD TREASURER1.00XX000
PATRICK MCPHERSON
BOARD SECRETARY1.00XX000
JOSIE ABBOUD
JDRF REP1.00X000
JOANN ABT
DIRECTOR AT LARGE1.00X000
ANN ANDERSON BERRY
MARCH OF DIMES REP1.00X000
VICKI ANZALONE
ADA REP1.00X000
GAVIN ATKINSON
DIRECTOR AT LARGE1.00X000
MARTIN BEERMAN
DIRECTOR AT LARGE1.00X000
PATRICK BOOTH
DIRECTOR AT LARGE1.00X000
SHARON BRODKEY
DIRECTOR AT LARGE1.00X000
TRACY CARTWRIGHT
CCFA REP1.00X000
MARTIE CORDARO
ALS REP1.00X000
LIZ CROSSON
ARTHRITIS REP1.00X000
MICHAEL DEMMAN
DIRECTOR AT LARGE1.00X000
EDWARD EASTERLIN
DIRECTOR AT LARGE1.00X000
DAVID GILINSKY
IMMEDIATE PAST CHAIR1.00X000
ROBERT GIRTHOFFER
NEBRAKSA AIDS REP1.00X000
LARRY GUENTHER
ALZHEIMER'S REP1.00X000
KERRY HEINRICH
NEBRAKSA KIDNEY REP1.00X000
LANCE JONES
PREVENT BLINDNESS REP1.00X000
STANLEY KATHOL
DIRECTOR AT LARGE1.00X000
CARRIE KEENE
WEST CENTRAL BOARD CHAIR1.00X000
KIRK KELLNER
DIRECTOR AT LARGE1.00X000
CINDY KEY
AMERICAN LUNG REP1.00X000
JIM LANDEN
DIRECTOR AT LARGE1.00X000
TERESA LAYTON
DIRECTOR AT LARGE1.00X000
THOMAS MACY
DIRECTOR AT LARGE1.00X000
LORI MCCLURG
LINCOLN BOARD CHAIR1.00X000
DEENIE MEYERSON
DIRECTOR AT LARGE1.00X000
ANGELA MILLER
SUSAN G KOMEN FOR THE CURE REP1.00X000
SCOTT MINER
DIRECTOR AT LARGE1.00X000
CLARENCE NICHOLS
STATE BOARD CHAIR ELECT1.00X000
SHANE OSBORN
DIRECTOR AT LARGE1.00X000
MARK OSTRONIC
NATIONAL MUTLIPLE SCLEROSIS REP1.00X000
STEVE PATTERSON
DIRECTOR AT LARGE1.00X000
STEPHEN PETERS
LEUKEMIA & LYMPHOMA REP1.00X000
BRIAN PICKERING
DIRECTOR AT LARGE1.00X000
AMBER PRESTON
DIRECTOR AT LARGE1.00X000
DAVID PROUGH
UNITED CEREBRAL PALSY REP1.00X000
TADD PULLIN
DIRECTOR AT LARGE1.00X000
DIANE RANDOLPH
NE HOSPICE & PALLIATIVE CARE REP1.00X000
ANDREW ROUILLARD
DIRECTOR AT LARGE1.00X000
CRAIG SALL
DIRECTOR AT LARGE1.00X000
LOREN STEENSON
DIRECTOR AT LARGE1.00X000
TARA STINGLEY
CFF REP1.00X000
FRANKLIN THOMPSON
DIRECTOR AT LARGE1.00X000
DR JODY WOODWORTH
DIRECTOR AT LARGE1.00X000
MICHELLE GROSSMAN
PRESIDENT/CEO40.007889509699X
WENDY OHL
DIRECTOR OF FIN & ADMIN40.004463402749X
FieldValueIRS element (for citing)
Total Reportable Comp From Org123529TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation12448TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns1499434FederatedCampaigns
All Other Contributions1233349AllOtherContributions
Total Contributions2732783TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
ADMINISTRATIVE FEES9000991414414144
LEADERSHIP 25 INCOME900099711711
FieldValueIRS element (for citing)
Total Program Service Revenue14855TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3TotalRevenueColumn
Exclusion$3ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2747641TotalRevenueColumn
Related Or Exempt Function Income14855RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2228555Total
Program Services2228555ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total135978Total
Program Services67989ProgramServices
Management And General61190ManagementAndGeneral
Fundraising6799Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total191031Total
Program Services153543ProgramServices
Management And General16367ManagementAndGeneral
Fundraising21121Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8763Total
Program Services7137ProgramServices
Management And General638ManagementAndGeneral
Fundraising988Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6420Total
Program Services5551ProgramServices
Management And General81ManagementAndGeneral
Fundraising788Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total23189Total
Program Services15773ProgramServices
Management And General5409ManagementAndGeneral
Fundraising2007Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total12973Total
Program Services10379ProgramServices
Management And General1297ManagementAndGeneral
Fundraising1297Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total7211Total
Program Services5048ProgramServices
Management And General1442ManagementAndGeneral
Fundraising721Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total34500Total
Program Services27001ProgramServices
Management And General4050ManagementAndGeneral
Fundraising3449Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total26044Total
Program Services20836ProgramServices
Management And General2604ManagementAndGeneral
Fundraising2604Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total9036Total
Program Services6777ProgramServices
Management And General452ManagementAndGeneral
Fundraising1807Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total4441Total
Program Services4270ProgramServices
Management And General38ManagementAndGeneral
Fundraising133Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4089Total
Program Services3271ProgramServices
Management And General409ManagementAndGeneral
Fundraising409Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total3573Total
Program Services2859ProgramServices
Management And General357ManagementAndGeneral
Fundraising357Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
AFFILIATION FEES358892871135893589
MISCELLANEOUS2183942826415
PUBLIC SECTOR FEES16831347168168
MEMBERSHIP DUES1255627314314

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2736813Total
Program Services2590616ProgramServices
Management And General99231ManagementAndGeneral
Fundraising46966Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY145BOY
EOY145EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY276675BOY
EOY245138EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1216000BOY
EOY1255147EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2370BOY
EOY4824EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis38943LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec27741LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY12603BOY
EOY11202EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY328085BOY
EOY341221EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY30506BOY
EOY31217EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1866384BOY
EOY1888894EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11772BOY
EOY5270EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1561253BOY
EOY1575925EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1573025BOY
EOY1581195EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-422809BOY
EOY-402284EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY379607BOY
EOY364451EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY336561BOY
EOY345532EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY293359BOY
EOY307699EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1866384BOY
EOY1888894EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10828ReconcilationRevenueExpenses
Reconcilation Other Changes3512ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2280698CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2460234CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2483443CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2533334CurrentTaxYearMinus1Year
Current Tax Year2732783CurrentTaxYear
Total12490492Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2280698CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2460234CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2483443CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2533334CurrentTaxYearMinus1Year
Current Tax Year2732783CurrentTaxYear
Total12490492Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total1460776AmountsSubstContributorsTotal
Public Support Total17011029716PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22182CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9908CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4509CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6106CurrentTaxYearMinus1Year
Current Tax Year3CurrentTaxYear
Total42708Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years998CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years745CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16297CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year18354CurrentTaxYearMinus1Year
Current Tax Year14855CurrentTaxYear
Total51249Total
FieldValueIRS element (for citing)
Total Support12584449TotalSupport
Public Support Pertcentage1700.87650PublicSupportPertcentage170
Public Support Pertcent Prior Year0.90610PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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 D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance365870BeginningOfYearBalance
Contributions8260Contributions
Investment Earnings Or Losses4225InvestmentEarningsOrLosses
End Of Year Balance378355EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance309525BeginningOfYearBalance
Contributions6600Contributions
Investment Earnings Or Losses49745InvestmentEarningsOrLosses
End Of Year Balance365870EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance281946BeginningOfYearBalance
Contributions8646Contributions
Investment Earnings Or Losses18933InvestmentEarningsOrLosses
End Of Year Balance309525EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance339458BeginningOfYearBalance
Contributions8915Contributions
Investment Earnings Or Losses-66427InvestmentEarningsOrLosses
End Of Year Balance281946EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.91320PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.08680TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis36812OtherCostOrOtherBasis
Depreciation26007Depreciation
Book Value10805BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2131OtherCostOrOtherBasis
Depreciation1734Depreciation
Book Value397BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings11202TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
PAYABLE TO AGENCIES - DESIGNATED$1,091,284
PAYABLE TO AGENCIES - UNDESIGNATED$484,641
FieldValueIRS element (for citing)
Total Of Amounts1575925TotalOfAmounts
Total Revenue2747641TotalRevenue
Total Expenses2736813TotalExpenses
Excess Or Deficit For Year10828ExcessOrDeficitForYear
Net Unrealized GL On Investments3512NetUnrealizedGLOnInvestments
Total Adjustments3512TotalAdjustments
Excess Or Deficit Per FS14340ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt889854TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments3512NetUnrealizedGainsInvestments
Revenue Not Rptd F9903512RevenueNotRptdF990
Revenue Subtotal886342RevenueSubtotal
Other Revenues Not Included1861299OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1861299RevenueNotRptdOnFinStmt
Total Revenue Per Form9902747641TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt875514TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal875514ExpensesSubtotal
Other Expenses Not Included1861299OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1861299ExpensesNotRptdOnFinStmt
Total Expenses Per Form9902736813TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:CHC HOLDS ENDOWMENT FUNDS FOR SUPPORT OF ITS PROGRAMS AND OPERATIONS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:COMBINED HEALTH AGENCIES DRIVE, INC. DBA COMMUNITY HEALTH CHARITIES OF NEBRASKA'S (CHC) OPERATION IS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAS RECEIVED A DETERMINATION LETTER THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. CHC ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. CHC RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2012 AND 2011, CHC EVALUATED ITS TAX POSITIONS AND CONCLUDED THAT IT HAD MAINTAINED ITS TAX EXEMPT STATUS AND HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. WITH FEW EXCEPTIONS CHC IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2009.
PART XII, LINE 4B - OTHER ADJUSTMENTS:FAS 136 ADJUSTMENT 1,861,299.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:FAS 136 ADJUSTMENT 1,861,299.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (35 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
ALZHEIMER'S ASSOCIATION GREAT PLAINS
5601 S 27TH ST STE 201LINCOLNNE68512480931989501(C)(3)93556GENERAL
ALZHEIMER'S ASSOCIATION MIDLANDS CHAPTER
CENTER MALL 1941 S 42ND ST STE 205OMAHANE68105470648438501(C)(3)94964GENERAL
AMERICAN CANCER SOCIETY
1100 PENNSYLVANIA AVENUEKANSAS CITYMO64105131788491501(C)(3)16687GENERAL
AMERICAN DIABETES ASSN OF NE
14216 DAYTON CIR STE 6OMAHANE68137131623888501(C)(3)82193GENERAL
AMERICAN LUNG ASSN OF THE CENTRAL STATES
8900 W DODGE RD STE 226OMAHANE68114430662525501(C)(3)40899GENERAL
ARTHRITIS FOUNDATION NEBRASKA CHAPTER
600 N 93RD ST STE 206OMAHANE68114470483544501(C)(3)42150GENERAL
BLAIR AREA COMMUNITY FOUNDATION
1646 WASHINGTON STBLAIRNE68008470825771501(C)(3)240317GENERAL
CROHN'S & COLITIS FOUNDATION OF NEBRASKA
1941 S 42ND ST STE 543OMAHANE68105136193105501(C)(3)27409GENERAL
CYSTIC FIBROSIS FOUNDATION NE CHAPTER
11917 PIERCE PLAZAOMAHANE68144131930701501(C)(3)49597GENERAL
JUVENILE DIABETES RESEARCH FOUNDATION
9202 WEST DODGE RD STE 304OMAHANE68114231907729501(C)(3)229350GENERAL
MARCH OF DIMES NEBRASKA CHAPTER
11840 NICHOLAS ST STE 220OMAHANE68154131846366501(C)(3)87631GENERAL
MUSCULAR DYSTROPHY ASSOCIATION
4654 S 132ND STOMAHANE68137131665552501(C)(3)28575GENERAL
NATIONAL MULTIPLE SCLEROSIS SOCIETY NE CHAPTER
328 S 72ND STOMAHANE68114470439079501(C)(3)99232GENERAL
NEBRASKA AIDS PROJECT
139 S 40TH STOMAHANE68131470786622501(C)(3)70149GENERAL
NEBRASKA HOSPICE & PALLIATIVE CARE PARTNERSHIP
3900 NW 12TH ST STE 100LINCOLNNE68521470673727501(C)(3)36888GENERAL
NEBRASKA KIDNEY ASSOCIATION INC
11725 ARBOR ST STE 210OMAHANE68114237225449501(C)(3)43021GENERAL
OMAHA CHRISTIAN ACADEMY
5612 L STOMAHANE68117470708320501(C)(3)18424GENERAL
OPEN DOOR MISSION
2828 NORTH 23RD STREET EASTOMAHANE68110470411375501(C)(3)24608GENERAL
PREVENT BLINDNESS NEBRASKA
6818 GROVER ST STE 102OMAHANE68106470539539501(C)(3)21333GENERAL
ST JUDE'S CHILDREN'S HOSPITAL
1830 CRAIG PARK DR STE 105ST LOUISMO63146351044585501(C)(3)25779GENERAL
SUSAN G KOMEN FOR THE CURE NEBRASKA
8610 BRENTWOOD DRIVE 3LAVISTANE68128260056671501(C)(3)131060GENERAL
THE ALS ASSN KEITH WORTHINGTON CHAPTER
10730 PACIFIC ST STE 228OMAHANE68114481021611501(C)(3)51663GENERAL
THE LEUKEMIA & LYMPHOMA SOCIETY
10832 OLD MILL ROAD STE 2OMAHANE68154135644916501(C)(3)122630GENERAL
UNITED CEREBRAL PALSY OF NEBRASKA
920 S 107TH ST STE 302OMAHANE68114470534212501(C)(3)29849GENERAL
MAKE A WISH FOUNDATION
11926 ARBOR ST STE 102OMAHANE68144470671096501(C)(3)14208GENERAL
UNITED WAY OF THE MIDLANDS
1805 HARNEY STOMAHANE68102470376605501(C)(3)5045GENERAL
NEBRASKA HUMANE SOCIETY
8929 FORT STREETOMAHANE68134473078997501(C)(3)6881GENERAL
ZION LUTHERAN CHURCH SCHOLARSHIP FUND
14205 IDA STREETOMAHANE68142470529151501(C)(3)9000GENERAL
EDUCATIONAL CONCERNS FOR HUNGER ORGANIZATIONS
17391 DURRANCE ROADNORTH FORT MYERSFL33917237275283501(C)(3)5040GENERAL
GOD OF WONDER
1386 S 1ST ST PO BOX 786HAMILTONMT59840260586277501(C)(3)5040GENERAL
HAITIAN AMERICAN FRIENDSHIP FOUNDATION
PO BOX 3421FORT MYERSFL33918953248186501(C)(3)5040GENERAL
IMPACTLIVES INC
6985 OXFORD STREETST LOUIS PARKMN55426830487437501(C)(3)6120GENERAL
LITTLE VIKES ATHLETIC ASSOCIATION AUXILLARY
2582 REDICK AVENUEOMAHANE68112470594972501(C)(3)6768GENERAL
PROJECT HARMONY
11949 Q STREETOMAHANE68137470789054501(C)(3)6093GENERAL
SUSAN G KOMEN FOR THE CURE
5005 LBJ FREEWAY STE 250DALLASTX75244751835298501(C)(3)7945GENERAL
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants35TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: FUNDS CONTRIBUTED BY DONORS IN WORKPLACE CAMPAIGNS CONDUCTED BY OR IN PARTNERSHIP WITH CHC-NE ARE EITHER DESIGNATED OR UNDESIGNATED FOR SPECIFIC AGENCIES. DESIGNATED FUNDS: AGENCIES ARE CREDITED WITH ALL SPECIFICALLY DESIGNATED FUNDS. DESIGNATED FUNDS ARE DISTRIBUTED QUARTERLY (SEPTEMBER, DECEMBER, MARCH AND JUNE) THE FISCAL YEAR FOLLOWING THE FISCAL YEAR IN WHICH THEY WERE PLEDGED. UNDESIGNATED FUNDS: THE UNDESIGNATED FUNDS, LESS EXPENSES ARE CREDITED TO EACH AGENCY IS BASED ON THE PERCENTAGE OF EACH AGENCY'S DESIGNATED FUNDS RELATIVE TO THE TOTAL OF ALL DESIGNATED FUNDS. THIS PERCENTAGE IS CALCULATED ANNUALLY AT THE END OF EVERY FISCAL YEAR FOR EACH AGENCY BY DIVIDING ITS DESIGNATED FUNDS BY THE TOTAL OF ALL DESIGNATED FUNDS FROM NON-FEDERAL CAMPAIGNS. UNDESIGNATED FUNDS ARE DISTRIBUTED FROM AVAILABLE COLLECTED RECEIVABLES ON THE LAST DAY OF EACH CALENDAR QUARTER (SEPTEMBER, DECEMBER, MARCH AND JUNE) THE AGENCIES ARE ALL 501(C)(3) ORGANIZATIONS ORGANIZED IN THE UNITED STATES.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE 990 TAX RETURN WILL BE E-MAILED TO EACH BOARD MEMBER AND THERE WILL BE AN OPPORTUNITY TO ASK QUESTIONS AT THE NEXT BOARD MEETING FOLLOWING THE DISBURSEMENT OF THE DOCUMENT.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY IS RENEWED EACH YEAR AND BOARD MEMBERS ARE ASKED TO DISCLOSE POTENTIAL CONFLICTS. THE CEO MONITORS THESE WITH THE ASSISTANCE OF THE ADMINISTRATIVE ASSISTANT. IF A CONFLICT EXISTS FOR A BOARD MEMBER IT IS ADDRESSED.
FORM 990, PART VI, SECTION B, LINE 15ATHE PRESIDENT & CEO POSITION IS REVIEWED ANNUALLY BY THE HUMAN RESOURCE COMMITTEE. THIS COMMITTEE CONSISTS OF THE BOARD CHAIR, IMMEDIATE PAST BOARD CHAIR AND AT LEAST THREE BUT NO MORE THAN FIVE OTHER BOARD MEMBERS. THIS COMMITTEE IS ALSO RESPONSIBLE FOR ANY OTHER HUMAN RESOURCE ISSUES THAT MAY ARISE WITH THE CEO. GOALS AND ACHIEVEMENTS ARE REVIEWED AS WELL AS ANNUAL SALARY INCREASE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 3,512.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:THE TREASURER OF THE BOARD IS THE CHAIRMAN OF THE FINANCE COMMITTEE. THE TREASURER ALONG WITH THE FINANCE COMMITTEE ASSUME RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.