2023-09-15T19:40:01-05:00 2022-10-31 221478099 COHNREZNICK LLP 14 SYLVAN WAY PARSIPPANY NJ 070543801 990 2021-11-01 753002264 COMMUNITY HEALTH CENTER OF SE KANSAS INC COMM 6202319873 3011 N MICHIGAN PO BOX 1832 PITTSBURG KS 667622546 ROSS TURNEY SVP CHIEF FINANCIAL OFFICER 6202319873 2023-09-15 1 ROSS TURNEY 999009999 LORI ROTHE YOKOBOSKY CPA P01273422 9732283500 2023-09-12 X 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z KRISTA POSTAI 3011 N MICHIGAN PO BOX 1832 PITTSBURG KS 667622546 92879987 0 X WWW.CHCSEK.ORG X 2002 KS TO PROVIDE QUALITY, AFFORDABLE, ACCESSIBLE MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE TO ANYONE REGARDLESS OF ABILITY TO PAY. 15 15 873 15 61353 0 23575982 22523217 28538531 37507658 -322807 -91299 24975531 23162798 76767237 83102374 0 0 0 0 46124172 54758098 0 0 555451 18230351 20861817 64354523 75619915 12412714 7482459 50466527 58510347 10394253 10980268 40072274 47530079 TO PROVIDE QUALITY, AFFORDABLE, ACCESSIBLE MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE TO ANYONE REGARDLESS OF ABILITY TO PAY. 0 0 56057461 60574515 PROVIDE MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES TO 72,000 INDIVIDUALS FOR 280,000 VISITS AT 35 CLINICS IN SOUTHEAST KANSAS AND NORTHEAST OKLAHOMA. FEES ARE BASED UPON ABILITY TO PAY, BUT ALL SERVICES PROVIDED REGARDLESS OF ABILITY TO PAY. CHC/SEK ALSO OFFERS SUBSTANCE ABUSE, PHARMACY AND ENABLING SERVICES. 56057461 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 93 0 1 873 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X ROSS TURNEY 6202319873 3011 N MICHIGAN PO BOX 1832 PITTSBURG KS 667622546 BRIAN JONES DIRECTOR 1.00 0.20 X 0 0 0 DANIEL MINNIS DDS DIRECTOR 1.00 0.10 X 0 0 0 DANNY MCCULLOUGH DIRECTOR 1.00 0.10 X 0 0 0 DAVID SHEPHERD TREASURER 1.00 0.10 X X 0 0 0 DAWN FLORES DIRECTOR 1.00 0.20 X 0 0 0 JAKE LETNER VICE CHAIR 1.00 0.20 X X 0 0 0 JANIE HENDERSON DIRECTOR 1.00 0.10 X 0 0 0 JERRY HAMM DIRECTOR 1.00 0.20 X 0 0 0 JOHN WYRICK DIRECTOR 1.00 0.10 X 0 0 0 JUDY WESTHOFF DIRECTOR 1.00 0.20 X 0 0 0 NANCY HAIRE SECRETARY 1.00 0.10 X X 0 0 0 PATRICK O'BRYAN CHAIR 1.00 0.10 X X 0 0 0 ROSE MADISON OUTGOING SECRETARY 1.00 0.10 X X 0 0 0 SHAWN NACCARATO DIRECTOR 1.00 0.20 X 0 0 0 TREVOR MELVIN DIRECTOR 1.00 0.10 X 0 0 0 KRISTA POSTAI CHIEF EXECUTIVE OFFICER 40.00 0.20 X 381951 0 22809 ROSS TURNEY SVP CHIEF FINANCIAL OFFICE 40.00 0.20 X 8792 0 155 DOUGLAS STUCKEY OUTGOING CHIEF FINANCIAL OFFICER 40.00 0.10 X 226222 0 765 HOLLY GAULT PHYSICIAN 40.00 X 317642 0 22501 JASON WESCO PRESIDENT, CHIEF STRATEGY OFFICER 40.00 X 284907 0 32923 JEQUITA SNYDER PHYSICIAN 40.00 X 305079 0 25375 MAXWELL SELF PHYSICIAN 40.00 X 349737 0 55795 PANKAJ GUGNANI PHYSICIAN 40.00 X 333763 0 22252 2208093 0 182575 103 0 1 0 TRUSTMARK (CORESOURCE) 62897 COLLECTION CENTER DR CHICAGO IL 60693 MEDICAL CLAIMS SERVICE 4115346 ECLINICALWORKS PO BOX 847950 BOSTON MA 02284 EMR PROVIDER 1688452 RX PREFERRED BENEFITS PO BOX 396 MT JULIET TN 37121 340(B) PHARMACY OVERLAY 425650 DOING STEEL FABRICATION LLC 2125 N GOLDEN SPRINGFIELD MO 65803 CONSTRUCTION 339013 ALLIANCE RADIOLOGY 8005 W 110TH ST STE 214 OVERLAND PARK KS 66210 IMAGING REVIEW SERVICE 326056 14 19643495 2879722 323991 22523217 MEDICAID 621110 16584973 16584973 THIRD PARTY PAYORS 621400 10792722 10792722 MEDICARE 621110 8339083 8339083 SELF-PAY 621400 1790880 1790880 37507658 145357 145357 68492 33904 34588 34588 34588 121965 358621 -236656 -236656 -236656 31135137 9385088 21750049 21688696 61353 PHYSICIAN INCENTIVES 900099 1211342 1211342 166819 166819 1378161 83102374 60574515 61353 -56711 775424 775424 42196553 30910556 10856684 429313 1697226 1239229 440786 17211 6935638 5005701 1860413 69524 3153257 2270345 851379 31533 33534 33534 119040 119040 4912726 4575120 337606 268705 268705 1262653 557910 699413 5330 2160432 1549030 609242 2160 813881 421535 392346 452038 220857 231181 26633 26633 28758 28758 1882141 1700983 180778 380 315196 216855 98341 MEDICAL EXPENSES 3481262 3481262 340B FILLING FEES 2594824 2594824 EQUIP REP. & MAINT. 1985285 1014554 970731 DUES & LICENSE FEES 292527 167094 125433 232182 131606 100576 75619915 56057461 19007003 555451 384484 319067 17974271 22523574 5211703 3908446 4311053 5134325 631781 809067 104370 136166 36299444 10683217 21765895 25616227 82970 63475 50466527 58510347 8806275 10093073 113143 37632 1474835 299082 0 550481 10394253 10980268 X 36495852 46420079 3576422 1110000 40072274 47530079 50466527 58510347 7482459 -24654 0 X 0 1 X 1 1 1 X 10019597 11683242 13709355 23575982 22523217 81511393 22971722 41113932 52460901 52380533 59196354 228123442 32991319 52797174 66170256 75956515 81719571 309634835 5700 5700 0 5700 5700 309629135 52724 221024 197122 152537 213849 837256 52724 221024 197122 152537 213849 837256 2928 61353 64281 184608 428245 1053043 1082418 1378161 4126475 33228651 53446443 67420421 77194398 83372934 314662847 0.98400 0.98660 0.00270 0.00250 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2017 AMOUNT: $ 184,608. 2018 AMOUNT: $ 428,245. 2019 AMOUNT: $ 1,053,043. 2020 AMOUNT: $ 139,548. 2021 AMOUNT: $ 166,819. PHYSICIAN INCENTIVES - 2020 AMOUNT: $ 942,870. 2021 AMOUNT: $ 1,211,342. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1672674 1672674 20823448 6170285 14653163 288456 33302 255154 7856126 4479630 3376496 5658740 5658740 25616227 DUE TO AFFILIATE 550481 550481 X 96110223 -24654 225428 3388083 3588857 92521366 -9418992 -9418992 83102374 87063464 225428 11218121 11443549 75619915 0 75619915 PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT, AS OF OCTOBER 31, 2022 AND 2021, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2019 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION REVENUE 3,388,083. PART XI, LINE 4B - OTHER ADJUSTMENTS: PHARMACY COST OF GOODS SOLD -9,385,088. RENTAL EXPENSE OFFSET -33,904. PART XII, LINE 2D - OTHER ADJUSTMENTS: PHARMACY COST OF GOODS SOLD 9,385,088. RELATED ORGANIZATION EXPENSES 1,799,129. RENTAL EXPENSE OFFSET 33,904. X X X 0 0 0 0 0 0 0 1 0 MAXWELL SELF PHYSICIAN 326697 0 22524 0 516 0 14260 0 41535 0 405532 0 0 0 KRISTA POSTAI CHIEF EXECUTIVE OFFICER 266227 0 115000 0 724 0 14260 0 8549 0 404760 0 0 0 PANKAJ GUGNANI PHYSICIAN 310059 0 23524 0 180 0 14260 0 7992 0 356015 0 0 0 HOLLY GAULT PHYSICIAN 299760 0 17774 0 108 0 14260 0 8241 0 340143 0 0 0 JEQUITA SNYDER PHYSICIAN 287779 0 17024 0 276 0 14260 0 11115 0 330454 0 0 0 JASON WESCO PRESIDENT, CHIEF STRATEGY OFFICER 234727 0 50000 0 180 0 14252 0 18671 0 317830 0 0 0 DOUGLAS STUCKEY OUTGOING CHIEF FINANCIAL OFFICER 200430 0 25000 0 792 0 0 0 765 0 226987 0 0 0 PART I, LINE 7 ANNUAL, END-OF-YEAR BONUSES WERE PROVIDED TO SELECTED STAFF. BOARD APPROVES CEO'S BONUS, CEO DETERMINES OTHER STAFF BONUSES. X 1 135869 X 4 188122 0 1 0 PART I, COLUMN (B): COLUMN B REPRESENTS NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B CHCSEK PREPARES AND CIRCULATES PROPOSED FORM 990 TO FINANCE COMMITTEE FOR DETAILED ANALYSIS, AND THEN REVIEWS PROPOSED FORM 990 WITH FULL BOARD BEFORE SUBMISSION. A COPY OF THE FILED RETURN IS MADE AVAILABLE TO THE FULL BOARD AFTER FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CHCSEK BOARD MEMBERS AND LEADERSHIP STAFF COMPLETE ANNUAL COMPLIANCE QUESTIONNAIRES TO DISCLOSE POSSIBLE CONFLICTS OF INTEREST AT ANY POINT DURING THE TAX YEAR, AND THEN REVIEWED BY THE COMPLIANCE OFFICER AND SHARED WITH FINANCIAL AUDITORS. NO SIGNIFICANT CONFLICTS WERE DISCLOSED IN THE FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION B, LINE 15 STAFF COMPENSATION IS LIMITED TO SALARY RANGES APPROVED BY THE BOARD OF DIRECTORS, AS DETERMINED BY THE CEO AND VP OF HUMAN RESOURCES, ASSISTED BY INDUSTRY-SPECIFIC SALARY SURVEYS AND COMPARABLE LOCAL NONPROFIT COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIALS AVAILABLE UPON REQUEST. BUILDING HEALTH INC 3015 N MICHIGAN STREET PITTSBURG KS 66762 844531146 NON-FQHC ACTIVITES KS 501(C)(3) LINE 12A, I COMMUNITY HEALTH CENTER OF SEK INC 1 INSPIRE HEALTH FOUNDATION INC 3015 N MICHIGAN STREET PITTSBURG KS 66762 880770422 FOUNDATION & EDUCATION KS 501(C)(3) LINE 7 COMMUNITY HEALTH CENTER OF SEK INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 BUILDING HEALTH INC P 1799129 ADMINISTRATIVE AGREEMENT