2011-02-02T10:38:26-06:00 2010-09-30 Christensen Brozek Faltys PC PO Box 1264 Norfolk NE 68702 990 2009-10-01 470833378 Norfolk Community Health Care Clinic In NORF 4026447314 110 N 16th Street Suite 16 Norfolk NE 68701 Kim Kwapnioski 4026447314 2011-01-10 1 Danny Fuerhoff CPA 4023711160 2009 2016-02-24 21:20:13Z Kim Kwapnioski 110 N 16th Street Suite 16 Norfolk NE 68701 2061302 0 X N/A X 1999 NE To provide access to quality primary health care and education on healthy living to all individuals in northeast Nebraska. 12 12 16 0 0 0 1158645 1289989 277307 768356 3578 2957 0 1439530 2061302 0 0 200927 753790 0 131791 1066665 1231232 1267592 1985022 171938 76280 515414 625590 117531 145225 397883 480365 To provide access to quality primary health care and education on healthy living to all individuals in northeast Nebraska. 0 0 1504277 768356 The organization provides medical services to the poor and uninsured or under-insured. The clinic seen patients from 18 different zip codes and had a total of 6,539 encounters/visits during 2009. Of this, they had 1,511 uninsured patients, 319 Medicaid patients, 124 Medicare patients and 472 private insurance patients. 1504277 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6 0 16 1 0 0 0 0 0 0 0 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X The Organization 4026447314 110 N 16th Street Suite 16 Norfolk NE 68701 Kathy Nordby 10.00 X 0 63798 0 Kim Kwapnioski 40.00 X 50699 0 0 Karen Weidner 8.00 X X 0 0 0 Joe Mtika 4.00 X X 0 0 0 Brenda Jones 4.00 X X 0 0 0 Doug Witte 4.00 X X 0 0 0 Pat Samuels 1.00 X 0 0 0 Betty Froehlich 1.00 X 0 0 0 Bernie Wrede 1.00 X 0 0 0 Mavis Hatcliff 1.00 X 0 0 0 Gretchen Forsell 1.00 X 0 0 0 Roger Davis 1.00 X 0 0 0 Jeanne Reigle 1.00 X 0 0 0 Marcus Rios 1.00 X 0 0 0 50699 63798 0 0 0 0 0 0 35033 1181362 73594 1289989 Patient revenue 621110 768356 768356 768356 2957 2957 2061302 768356 0 2957 645273 387164 193582 64527 108517 65110 32555 10852 14125 5650 5650 2825 14008 14008 598559 518082 44159 36318 14796 2959 740 11097 171848 164536 5475 1837 10810 4324 4324 2162 53400 48060 5340 11988 1199 9590 1199 11446 1145 9729 572 30082 15041 15041 20075 17485 2396 194 Bad debt expense 197464 197464 Lab fees 40738 40738 Repairs & maintenance 16323 16323 Recruitment/hiring 11378 11378 Health education 5958 5958 8234 1661 6365 208 1985022 1504277 348954 131791 122509 207658 176512 86708 1200 195620 33914 216393 161706 168318 515414 625590 117531 145225 117531 145225 X 397883 480365 397883 480365 515414 625590 X 0 1 1 X 1 1 X 236998 107502 90100 1194995 1289989 2919584 236998 107502 90100 1194995 1289989 2919584 2919584 1713 4313 3000 3578 2957 15561 10225 1304 2463 13992 2949137 1353749 0.99000 0.98510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 72907 24936 47971 122713 8978 113735 161706 2061302 1985022 76280 6201 1 6202 82482 2104568 43266 43266 2061302 0 2061302 2028287 43266 43266 1985021 1 1 1985022 Part X: Description of Uncertain Tax Positions Under FIN 48: In July 2006, the Financial Accounting Standards Board (FASB) issued FASB Interpretation No. 48 (FIN 48), Accounting for Uncertainty in Income Taxes an interpretation of FASB Accounting Standards Codification (ASC) 740, Income Taxes. FIN 48 attempts to set out a consistent framework for preparers to use to determine the appropriate level of tax reserve to maintain for uncertain tax positions. This interpretation of ASC 740 uses a two-step approach wherein tax benefit is recognized if a position is more-likely-than-not to be sustained. The amount of the benefit is then measured to be the highest tax benefit which is greater than 50% likely to be realized. FIN 48 also sets out disclosure requirements to enhance transparency of an entitys tax reserves. The Organization adopted the current accounting standard related to unrecognized tax benefits on October 1, 2009. The Organization files required income tax returns in the U.S. federal jurisdiction and various states. With few exceptions, the Organization is no longer subject to U.S. federal, state and local income tax examinations by tax authorities for years before 2006. As a result of the implementation of FIN 48, the Organization has concluded no material uncertain tax positions have been taken on any open tax returns. For the current year the Organization believes all tax positions are fully supportable by existing Federal law and related interpretations and there are no uncertain tax positions to consider in accordance with FIN 48. Part XI, Line 8 - Other Adjustments: Rounding: 1. Part XIII, Line 4b - Other Adjustments: Rounding: 1. Form 990, Part VI, Section B, line 11 A copy of the Form 990 is provided to the board for review before it is filed. Form 990, Part VI, Section B, line 12c Any conflicts of interest are discussed among the board. A conflict of interest form must be completed and signed by each board member annually. Form 990, Part VI, Section C, line 19 The Organization's governing documents are made available to the public upon request. Form 990, Part XI, Line 2c This process has not changed from the prior year.