2022-12-13T13:25:38-06:00 2022-01-31 FORVIS LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2021-02-01 421060724 COMMUNITY HEALTH CARE INC % KEVIN HAGEDORN COMM 5633363000 500 WEST RIVER DRIVE DAVENPORT IA 528011014 KEVIN HAGEDORN CFO 5633363000 2022-10-04 true KEVIN HAGEDORN 999009999 Krystal K Creach P01248198 4178658701 2 2021 2022-09-23 18:48:47Z TOM BOWMAN 500 WEST RIVER DRIVE DAVENPORT IA 528011014 41063695 false X WWW.CHCQCA.ORG X 1975 IA COMMUNITY HEALTH CARE PROVIDES PRIMARY MEDICAL, DENTAL, AND BEHAVIORAL HEALTH CARE TO INDIVIDUALS IN THE COMMUNITIES THEY SERVE. 15 15 444 21 850 0 18802895 10679363 25094855 30169323 26806 51288 60223 72082 43984779 40972056 0 0 0 0 23784074 26680825 0 0 175778 11304418 12112635 35088492 38793460 8896287 2178596 35608530 35997390 9479287 7689551 26129243 28307839 COMMUNITY HEALTH CARE PROVIDES THE COMMUNITIES WE SERVE WITH EXCELLENCE IN PATIENT-CENTERED MEDICAL, DENTAL, AND BEHAVIORAL HEALTH CARE THAT IS COMPASSIONATE, AFFORDABLE, AND ACCESSIBLE. false false 20379763 23160289 COMMUNITY HEALTH CARE, INC., PROVIDES PRIMARY MEDICAL CARE IN EIGHT LOCATIONS IN BOTH IOWA AND ILLINOIS. MEDICAL SERVICES INCLUDE INTERNAL MEDICINE, FAMILY PRACTICE, PEDIATRICS, LABORATORY, PHARMACY, AND OB/GYN. MEDICAL PATIENTS SERVED DURING FISCAL YEAR 2022 WERE 32,977 IN 97,083 MEDICAL VISITS. THOSE WHO QUALIFY ARE OFFERED A SLIDING FEE SCALE. 4495536 4875850 COMMUNITY HEALTH CARE, INC. PROVIDES DENTAL CARE IN THREE LOCATIONS IN BOTH IOWA AND ILLINOIS. DENTAL PATIENTS SERVED WERE 13,363 IN 28,141 DENTAL VISITS. ALL PEOPLE IN NEED ARE SERVED. THOSE WHO QUALIFY ARE OFFERED A SLIDING FEE SCALE. 1798214 2133184 COMMUNITY HEALTH CARE, INC. PROVIDES BEHAVIORAL HEALTH CARE IN FIVE LOCATIONS IN BOTH IOWA AND ILLINOIS. BEHAVIORAL HEALTH PATIENTS SERVED WERE 3,799 IN 13,974 VISITS. ALL PEOPLE IN NEED ARE SERVED. THOSE WHO QUALIFY ARE OFFERED A SLIDING FEE SCALE. 26673513 true true false true false false false false false true true false false false false false true false false false false false false false false false false false false true true false false false false false false false false false false true false false false false false false false false true 30 0 true 444 true false false false false false false false false false false false false X 15 15 false false false false false false false true true false false true true true true true true true true false IL X KEVIN HAGEDORN 5633363000 500 WEST RIVER DRIVE DAVENPORT IA 52801 REBECCA M HAYES CHIEF MEDICAL OFFICER 40.0 0.0 X 327991 0 29804 CHETAN PRASAD PHYSICIAN 40.0 0.0 X 307497 0 24577 SWETHA R KANDULA PHYSICIAN 40.0 0.0 X 270973 0 27312 ANNE M METUGE PHYSICIAN 40.0 0.0 X 262973 0 27886 JOELLE M MENGANG PHYSICIAN 40.0 0.0 X 249516 0 29209 THOMAS J BOWMAN CHIEF EXECUTIVE OFFICER 40.0 0.0 X 249700 0 24715 HUSAM GHAWI PHYSICIAN 40.0 0.0 X 227937 0 25192 MARK STUMPHY DENTAL DIRECTOR/DENTIST 40.0 0.0 X 214094 0 20361 KEVIN P HAGEDORN CHIEF FINANCIAL OFFICER 40.0 0.0 X 150056 0 22823 DARRYL DOPSON DIRECTOR 1.0 0.0 X 0 0 0 PHYLLIS MULLETT DIRECTOR 1.0 0.0 X 0 0 0 LISA RANDOLPH DIRECTOR 1.0 0.0 X 0 0 0 KRISTEN HUMPHRIES DIRECTOR BEGIN 11/21 1.0 0.0 X 0 0 0 ANNA MORENO DRIECTOR 1.0 0.0 X 0 0 0 SARAH WELLS DIRECTOR 1.0 0.0 X 0 0 0 GLORIA PICKENS DIRECTOR BEGIN 11/21 1.0 0.0 X 0 0 0 KEVIN JOHNSON DIRECTOR 1.0 0.0 X 0 0 0 TODD WILSON DIRECTOR 1.0 0.0 X 0 0 0 ANITA GOMEZ-JONES SECRETARY END/CHAIR BEG 11/21 1.0 0.0 X X 0 0 0 DAVE HELSCHER TREAS. END/DIRECTOR BEG 11/21 1.0 0.0 X X 0 0 0 ANTHONY SCHWENKE CHAIR END/DIRECTOR BEG 11/21 1.0 0.0 X X 0 0 0 KATIE SPAIN DIRECTOR/VICE CHAIR BEG 11/21 1.0 0.0 X X 0 0 0 SARAH MOORE DIRECTOR END/SECTRY. BEG 11/21 1.0 0.0 X X 0 0 0 VADEN SPURLOCK DIRECTOR END/TREAS. BEG 11/21 1.0 0.0 X X 0 0 0 JORDAN KAPLAN VICE CHAIR/DIRECTOR END 11/21 1.0 0.0 X X 0 0 0 2260737 0 231879 55 false true false ROBERT YOUNG CENTER 4600 3RD STREET MOLINE IL 61265 BEHAV HLTH PROVIDERS 1030851 GENESIS 1227 E RUSHOLME ST DAVENPORT IA 52803 OBGYN PROVIDERS 471086 STRATUS INDEMAND PO BOX 675248 DETROIT MI 48267 TRANSLATIONS SERVICE 336944 BKD LLP 910 E ST LOUIS ST SPRINGFIELD MO 65801 ACCOUNTING SERVICES 185950 4 176331 9072224 1430808 60266 10679363 NET PATIENT SERVICE REVENUE 624100 29896285 29896285 OTHER INCOME 624100 273038 272188 850 30169323 84019 84019 0 0 130990 58908 72082 0 72082 72082 32731 -32731 -32731 -32731 0 0 0 0 0 0 0 0 0 0 40972056 30168473 850 123370 X 0 0 0 0 1039544 592250 447294 0 20976969 14860796 6018779 97394 631021 442307 184043 4671 2489437 1547310 935610 6517 1543854 990803 544868 8183 0 50331 50331 206909 206909 0 0 0 4644285 3543106 1097625 3554 75999 25867 50132 264339 109341 154216 782 1396028 205397 1190141 490 0 693479 542772 149967 740 98203 37708 60495 0 108036 64786 41120 2130 120900 7964 112936 0 1349267 985583 363684 175972 107403 68017 552 MEDICAL SUPPLIES AND DRUGS 2360193 2360193 LICENSES, DUES, SUBSCRIPTIONS 240469 84666 155312 491 REPAIRS AND MAINTENANCE 217557 151601 65814 142 RECRUITMENT AND RETENTION 98104 13660 84444 12564 12564 38793460 26673513 11944169 175778 673689 777509 12961286 13781501 1475057 1402950 4163579 3893637 0 0 0 0 0 0 98000 94873 394642 503699 28309399 12895794 15763839 15413605 0 0 0 0 0 0 0 0 78438 129616 35608530 35997390 5038034 5273942 0 0 822409 938264 1519850 1138510 0 0 0 0 2098994 338835 0 0 0 0 9479287 7689551 X 25509090 27430950 620153 876889 26129243 28307839 35608530 35997390 2178596 X false true X true true true X 6357651 7135221 7018919 18802895 10679363 49994049 0 0 6357651 7135221 7018919 18802895 10679363 49994049 0 49994049 48572 68129 157857 157786 215009 647353 1000 850 850 850 850 4400 0 50645802 128104121 0.98713 0.98953 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false false false false true false true false SCHEDULE C, PART II-B, LINES 1(A), 1(B), AND 1(G) LOBBYING ACTIVITIES: THE ORGANIZATION WILL FROM TIME TO TIME ASK ITS BOARD MEMBERS, LEADERSHIP TEAM, AND EMPLOYEES TO CONTACT THEIR LOCAL LEGISLATORS IF THERE IS PENDING LEGISLATION THAT COULD HELP OR HARM THE HEALTH CENTER. THE SUM TOTAL OF THE TIME AND EFFORTS THE HEALTH CENTER SPENDS ON DIRECT LOBBYING EFFORTS IS NOT MATERIAL TO THE OVERALL EXPENSES OF THE ORGANIZATION. SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE ILLINOIS PRIMARY CARE ASSOCIATION AND THE IOWA PRIMARY CARE ASSOCIATION. A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING EXPENSES. HOWEVER, A REVIEW OF THESE ORGANIZATIONS' FORM 990 RETURNS REVEAL NO POLITICAL ACTIVITY HAS OCCURRED WITH THE USE OF THESE DUES. 45393 95 6071 1502 441 49616 43250 100 3880 1400 28 409 45393 36785 200 6904 639 43250 39055 1065 -2666 669 36785 33109 1855 4703 613 612 38442 1.00000 true false 1516265 1516265 18387001 8370380 10016621 2244857 541093 1703764 5937743 3984321 1953422 223533 223533 15413605 40824059 17100 545904 563004 40261055 711001 711001 40972056 38902199 17100 91639 108739 38793460 38793460 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS: A FUND WAS SET UP TO HONOR DR. MARY MARIANI, DDS WHO BELIEVED EVERYONE DESERVES A BEAUTIFUL SMILE. THE FUNDS ARE TO BENEFIT THE CHC DENTAL CLINICS WHERE MARY SERVED FOR OVER 25 YEARS. VALUE $6,026. A FUND WAS ESTABLISHED DECEMBER 23, 1999 BY MATERNAL HEALTH CENTER, INC. WITH THE MERGER OF MATERNAL HEALTH AND COMMUNITY HEALTH CARE, INC. APRIL 1, 2016 THE ENDOWMENT WAS RE DESIGNATED TO CHC TO BE USED FOR WOMEN'S HEALTH. VALUE $43,590. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IS ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT FORM 990, PART VIII, LINE 12: $ 545,904 NET ASSETS RELEASED SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 802,640 TRNA CONTRIBUTIONS (58,908) RENTAL EXPENSES (32,731) LOSS ON DISPOSAL OF ASSET ---------- $ 711,001 SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 802,640 TRNA CONTRIBUTIONS (58,908) RENTAL EXPENSES (32,731) LOSS ON DISPOSAL OF ASSET ---------- $ 711,001 X X X true false false false false true false true false THOMAS J BOWMAN CHIEF EXECUTIVE OFFICER 225016 0 20000 0 4684 0 10999 0 13716 0 274415 0 0 0 KEVIN P HAGEDORN CHIEF FINANCIAL OFFICER 139759 0 10000 0 297 0 7291 0 15532 0 172879 0 0 0 CHETAN PRASAD PHYSICIAN 282479 0 24845 0 173 0 13476 0 11101 0 332074 0 0 0 SWETHA R KANDULA PHYSICIAN 252798 0 18000 0 175 0 13102 0 14210 0 298285 0 0 0 ANNE M METUGE PHYSICIAN 259757 0 3000 0 216 0 13067 0 14819 0 290859 0 0 0 JOELLE M MENGANG PHYSICIAN 242175 0 7142 0 199 0 11538 0 17671 0 278725 0 0 0 HUSAM GHAWI PHYSICIAN 181467 0 11654 0 34816 0 9944 0 15248 0 253129 0 0 0 REBECCA M HAYES CHIEF MEDICAL OFFICER 77041 0 30000 0 220950 0 14022 0 15782 0 357795 0 0 0 MARK STUMPHY DENTAL DIRECTOR/DENTIST 183921 0 30000 0 173 0 9346 0 11015 0 234455 0 0 0 SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENT: THE FOLLOWING EMPLOYEE RECEIVED A SEVERANCE PAYMENT IN THE CURRENT YEAR: -REBECCA M. HAYES $200,000 SETTLEMENT AGREEMENT SCHEDULE J, PART I, LINE 6A BONUSES CONTINGENT ON NET EARNINGS: THE ORGANIZATION HAS ESTABLISHED AN INCENTIVE PLAN THAT IS DEPENDENT UPON THE ORGANIZATION MEETING CERTAIN NET EARNINGS TARGETS. AFTER THE ORGANIZATION MEETS THESE TARGETS, THE PLAN ALLOWS FOR STAFF TO EARN A BONUS BASED ON A PERCENTAGE OF THEIR ANNUAL COMPENSATION IF THE STAFF MEETS TARGETS BASED ON THEIR INDIVIDUAL PERFORMANCE, PATIENT EXPERIENCE TARGETS AND STAFF ENGAGEMENT TARGETS. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: THE BONUS IS FACTORED ON SEVERAL ITEMS. THE MAIN PORTION OF THE BONUS IS GENERATED BY PATIENT VOLUME. EACH PROVIDER HAS A MINIMUM NUMBER OF FACE TO FACE BILLABLE ENCOUNTERS THAT THEY NEED TO SEE ON A YEARLY BASIS. THE MINIMUM NUMBER IS ADJUSTED ACCORDING TO SPECIALTY AND CLINIC TYPE, I.E. DENTISTS VS. INTERNIST. ONCE THE PROVIDER HAS MET THE MINIMUM NUMBER OF FACE TO FACE BILLABLE ENCOUNTERS, THEY BEGIN TO ACCRUE A BONUS FOR EACH PATIENT THEY SEE. THERE ARE ALSO QUALITY INDICATORS THAT ARE TRACKED FOR EACH PROVIDER WHICH CAN EARN THEM SMALL BONUSES. EXAMPLES WOULD BE: TIMELY DICTATION, PATIENT SATISFACTION, A1C LEVELS UNDER CONTROL FOR DIABETICS, PROPER IMMUNIZATIONS GIVEN FOR CHILDREN, ETC. THESE QUALITY INDICATORS ARE ALSO SPECIFIC TO THE PROVIDER TYPE. A CITY OF BUFFALO IOWA 426004303 000000000 2017-11-01 2694000 REFUND PRIOR ISSUE 2003 BOND false false false A 1542224 0 2694000 0 0 0 33802 0 0 0 2660198 0 1997 true false true true A false true false false false false 0 true false false false A false false true false false false 0 false false false 0 false false A false X 9 60266 FMV false true false SCHEDULE M, PART I, COLUMN (B) NUMBER OF CONTRIBUTORS: THE NUMBER ENTERED IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 11B REVIEW PROCESS OF 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIALS STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF COMMUNITY HEALTH CARE INC. THE CHIEF FINANCIAL OFFICER OF THE ORGANIZATION FIRST REVIEWS THE RETURN SEPARATELY IN DETAIL. AFTER THIS REVIEW, THE AUDIT COMMITTEE REVIEWS THE FORM 990 AND RECOMMENDS FILING TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS THEN PROVIDED A COPY OF THE RETURN AND AUTHORIZES FILING. THE BOARD IS ALLOWED TO ASK QUESTIONS AND MAKE COMMENTS REGARDING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY COMPLIANCE: ALL CONFLICTS ARE MONITORED THROUGHOUT THE YEAR. IF A POTENTIAL CONFLICT ARISES, THE BOARD WOULD BE NOTIFIED AND STEPS ARE TAKEN TO REMEDY THE CONFLICT. IF A QUESTION CONCERNING A CONFLICT OF INTEREST FOR ANY DIRECTOR IS RAISED, AND IN THE ABSENCE OF THE DIRECTOR RECUSING HIM OR HERSELF, A WRITTEN SECRET BALLOT MAY BE USED BY THE REMAINING DIRECTORS TO DETERMINE IF SUCH CONFLICT OF INTEREST EXISTS. SHOULD A CONFLICT OF INTEREST, PECUNIARY OR OTHERWISE, BE DETERMINED FOR ANY DIRECTOR, SUCH DIRECTOR SHALL BE EXCLUDED FROM VOTING ON THAT SUBJECT MATTER. A SIMPLE AFFIRMATIVE MAJORITY OF THOSE PRESENT SHALL RULE. IN ALL EVENTS, A DIRECTOR SHALL DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION DETERMINATION POLICY: THE CEO IS A CONTRACTED EMPLOYEE. THE BOARD OF DIRECTORS COMPLETES A PERFORMANCE REVIEW IN WRITING ON AN ANNUAL BASIS BASED ON COMPENSATION SURVEYS CONDUCTED ANNUALLY BY THE PRIMARY CARE ASSOCIATIONS IN IOWA AND ILLINOIS AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. AT THAT TIME, THEY MAY AWARD A DISCRETIONARY BONUS OR MERIT INCREASE BASED UPON CEO AND ORGANIZATIONAL PERFORMANCE. CHANGES TO SALARY ARE NOTED IN THE CONTRACT. THE ORIGINAL, CURRENT CONTRACT IS HOUSED WITH HUMAN RESOURCES AND A COPY GOES TO PAYROLL. THE LAST COMPENSATION REVIEW WAS PERFORMED IN 2022. FORM 990, PART VI, SECTION B, LINE 15B COMPENSATION DETERMINATION POLICY: OTHER OFFICER AND KEY EMPLOYEE COMPENSATION DETERMINATION POLICY: COMPENSATION FOR KEY EMPLOYEE IS SET BY THE CEO AND DIRECTOR OF HUMAN RESOURCES BASED ON COMPENSATION SURVEYS CONDUCTED ANNUALLY BY THE PRIMARY CARE ASSOCIATION IN IOWA AND ILLINOIS AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. THE LAST COMPENSATION REVIEW WAS PERFORMED IN 2022. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE POLICY: THE ORGANIZATION'S FINANCIAL STATEMENTS, IRS FORM 990, AND OTHER DOCUMENTS AND POLICIES ARE MADE AVAILABLE TO INTERESTED PARTIES, UPON REQUEST, FOR VIEWING ON-SITE. FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED 340B FEES TOTAL FEES:1147731 FORM 990 PART IX LINE 11G DESCRIPTION:ROBERT YOUNG CONTRACTED PROVID TOTAL FEES:1030851 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:577244 FORM 990 PART IX LINE 11G DESCRIPTION:GENESIS CONTRACTED PROVIDERS TOTAL FEES:471086 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSLATION FEES TOTAL FEES:332717 FORM 990 PART IX LINE 11G DESCRIPTION:LABORATORY CORPORATION TOTAL FEES:236950 FORM 990 PART IX LINE 11G DESCRIPTION:CORONIS TOTAL FEES:95040 FORM 990 PART IX LINE 11G DESCRIPTION:ASCENTIS TOTAL FEES:90751 FORM 990 PART IX LINE 11G DESCRIPTION:MEDPRO WASTE DISPOSAL TOTAL FEES:88615 FORM 990 PART IX LINE 11G DESCRIPTION:HURON CONSULTING TOTAL FEES:87972 FORM 990 PART IX LINE 11G DESCRIPTION:PAIN CENTERS OF IA RD PROVIDER TOTAL FEES:67320 FORM 990 PART IX LINE 11G DESCRIPTION:UNIV. OF IA DENTAL PROVIDERS TOTAL FEES:62112 FORM 990 PART IX LINE 11G DESCRIPTION:REPUBLIC SERVICES TOTAL FEES:54540 FORM 990 PART IX LINE 11G DESCRIPTION:ACCESS SYSTEM LEASING TOTAL FEES:50937 FORM 990 PART IX LINE 11G DESCRIPTION:PHELPS UNIFORM SPECIALIST TOTAL FEES:44018 FORM 990 PART IX LINE 11G DESCRIPTION:FRANKLIN PEDIATRICS & PROVIDER TOTAL FEES:47100 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL OFFICE SERVICES TOTAL FEES:41023 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL PROSTHETICS TOTAL FEES:32841 FORM 990 PART IX LINE 11G DESCRIPTION:QC DENTAL LABORATORY TOTAL FEES:28621 FORM 990 PART IX LINE 11G DESCRIPTION:PHONE TREE TOTAL FEES:23766 FORM 990 PART IX LINE 11G DESCRIPTION:TORI SQUIRES TOTAL FEES:15150 FORM 990 PART IX LINE 11G DESCRIPTION:LIFESTRATEGIES TOTAL FEES:12500 FORM 990 PART IX LINE 11G DESCRIPTION:JAMES PATTON TOTAL FEES:5400