2023-02-28T14:49:50-06:00 2022-06-30 FORVIS LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2021-07-01 237076080 CRUSADERS CENTRAL CLINIC ASSOCIATION % LUIS DELGADO CRUS 8154901600 1200 WEST STATE STREET ROCKFORD IL 61102 SAMUEL MILLER CEO 8154901600 2023-02-28 true SAMUEL MILLER 999009999 Krystal K Creach P01248198 4178658701 2023-03-15 3 2021 2023-04-26 12:10:37Z SAMUEL MILLER 1200 WEST STATE STREET ROCKFORD IL 61102 62400446 false X WWW.CRUSADERHEALTH.ORG X 1972 IL CRUSADER COMMUNITY HEALTH IS A COMMUNITY-BASED, NOT-FOR-PROFIT COMMUNITY HEALTH CENTER. SEE SCHEDULE O FOR MORE INFORMATION. 14 14 431 14 0 0 13933232 18016055 38323985 40554511 1522052 1205213 6501 11973 53785770 59787752 0 0 0 0 29941120 31564063 0 0 0 17169717 17102672 47110837 48666735 6674933 11121017 89366480 89354596 11879033 6379934 77487447 82974662 X CRUSADER COMMUNITY HEALTH SERVES THE ROCK RIVER VALLEY AREA WITH QUALITY PRIMARY CARE FOR ALL PEOPLE IN NEED. false false 25686694 25738400 CRUSADER COMMUNITY HEALTH'S MEDICAL SERVICE MODEL EMPHASIZES HIGH QUALITY SERVICES, CONTINUITY OF CARE, EFFICIENT OPERATIONS, AND CONTINUOUS IMPROVEMENT. THE MEDICAL DEPARTMENT OFFERS A FULL ARRAY OF PRIMARY MEDICAL CARE SERVICES FOR PATIENTS OF ALL AGES. MEDICAL SERVICES ARE FOCUSED IN THE AREAS OF PEDIATRICS, FAMILY PRACTICE, INTERNAL MEDICINE AND SPECIALTY SERVICES. SEE SCHEDULE O FOR ADDITIONAL PROGRAM DESCRIPTIONS. 8428489 9137163 WOMEN'S HEALTH SERVICES DEPARTMENT PROVIDES PRENATAL CARE, WELLNESS EXAMS, CANCER SCREENING AND FOLLOW-UP, AND GYNECOLOGIC SERVICES. SERVICES ARE PROVIDED BY A TEAM OF OBSTETRICIANS, FAMILY PRACTITIONERS, CERTIFIED NURSE MIDWIVES AND NURSE PRACTITIONERS. 4261352 4710488 CRUSADER COMMUNITY HEALTH'S DENTAL PROGRAM'S FOCUS IS ON PREVENTIVE EXAMS WHILE ALSO PROVIDING FILLINGS, CLEANINGS AND EMERGENCY TREATMENT FOR CHILDREN AND ADULTS. DENTAL SERVICES FOR CHILDREN AR AVAILABLE AT MOST CRUSADER COMMUNITY HEALTH LOCATIONS. ADULT SERVICES ARE OFFERED AT THE WEST STATE STREET AND BROADWAY LOCATION. 403134 968460 38779669 true true false true false false false false false false true false false true false false true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false true 27 0 true 431 true false false false false false false false false false false false false X 14 14 false false false false false false false true true false false true true true true true true true false false IL X LUIS DELGADO 8154901600 1200 WEST STATE STREET ROCKFORD IL 61102 ANTOUN AL KHABBAZ WHS - DEPT CHAIR 40.0 0.0 X 574585 0 40291 SAMUEL MILLER CEO 40.0 0.0 X 399514 0 44416 SARA ZIBERT PEDIATRICS-DEPTCHAIR END 12/21 40.0 0.0 X 268603 0 13443 TERRY WHITE COO 40.0 0.0 X 237243 0 35131 NIVEDITA KARMAKAR PHYSICIAN 40.0 0.0 X 227927 0 42572 MARIA CASTILLO-CLAVIJO PHYSICIAN 40.0 0.0 X 231998 0 38273 MANINDER KAUR PHYSICIAN 40.0 0.0 X 220432 0 21676 KIMBERLY MILLER FAMILY MEDICINE - DEPT CHAIR 32.0 0.0 X 224534 0 10095 VILMA RAMIREZ-FLAMENCO PHYSICIAN 40.0 0.0 X 212383 0 10182 JITHINRAJ EDAKKANAMBETH VARAYIL PHYSICIAN 40.0 0.0 X 191183 0 22953 LUIS DELGADO VP FINANCE 40.0 0.0 X 119228 0 34967 BARBARA WILLIAMS DIRECTOR 1.0 0.0 X 0 0 0 CAROL JACKSON DIRECTOR 1.0 0.0 X 0 0 0 CATHERINE BROWN CHAIR 1.0 0.0 X X 0 0 0 DAVID POWELL DIR; CHAIR QUAL OP BEG 01/22 1.0 0.0 X X 0 0 0 DENNIS ROOP DIRECTOR 1.0 0.0 X 0 0 0 EDDIE VALDES IMMEDIATE PAST CHAIR 1.0 0.0 X X 0 0 0 JAMES MILLIKIN TREASURER 1.0 0.0 X X 0 0 0 JANICE FORREST DIRECTOR 1.0 0.0 X 0 0 0 KRIS HARDEN DIRECTOR 1.0 0.0 X 0 0 0 LEON HANSEN DIRECTOR 1.0 0.0 X 0 0 0 LUZ RAMIREZ DIRECTOR 1.0 0.0 X 0 0 0 PETER MAZANEC DIRECTOR 1.0 0.0 X 0 0 0 RICHARD WALSH VICE CHAIR 1.0 0.0 X X 0 0 0 DAVID RUFFIN DIRECTOR BEG 5/22 1.0 0.0 X 0 0 0 2907630 0 313999 73 false true false STENSTROM GENERAL CONTRACTOR 2420 20TH ST ROCKFORD IL 61104 CONSTRUCTION 2584167 FURST STAFFING SERVICES 2580 CHARLES ST ROCKFORD IL 61108 TEMPORARY STAFF 551212 KLH CONSULTING 2324 BETHARDS DR SANTA ROSA CA 95405 IT CONSULTING 444788 ECLINICALWORKS LLC 2 TECHNOLOGY DR WESTBOROUGH IL 01581 EMR MAINTENANCE 433571 VANS BUILDING SERVICE 633 PROGRESSIVE LN UNIT 1 ROCKFORD IL 61108 JANITORIAL 308544 11 17490847 525208 18016055 NET PATIENT SERVICE REVENUE 624100 40007608 40007608 MANAGEMENT FEES 624100 176726 176726 OTHER REVENUE 624100 370177 370177 40554511 1257700 1257700 0 0 11973 11973 0 11973 11973 2560207 2612694 -52487 -52487 -52487 0 0 0 0 0 0 0 0 0 0 59787752 40554511 1217186 0 0 0 0 2002050 1345560 656490 0 24119925 19130201 4989724 602964 512427 90537 2996654 2484167 512487 1842470 1539025 303445 0 199922 199922 128720 128720 0 0 0 4258050 3040164 1217886 44990 44990 600560 432288 168272 0 409462 136238 273224 0 905315 711321 193994 106203 68919 37284 0 158551 118225 40326 5796 5796 0 2190535 1721139 469396 0 MEDICAL SUPPLIES & DRUGS 6446160 6446160 REPAIRS & MAINTENANCE 1348646 992901 355745 LICENSES, DUES, SUBSCRIPTIONS 250267 100934 149333 RECRUITING AND RETENTION 49495 49495 48666735 38779669 9887066 0 0 0 9556644 9735638 7707 934 3661703 2545220 0 0 0 0 0 0 104032 65715 369419 241615 46732863 18307642 28416973 28425221 36610563 39771351 0 0 0 0 0 0 10639439 8568902 89366480 89354596 6915717 6317466 0 0 370016 62468 0 0 0 0 0 0 4593300 0 0 0 0 0 11879033 6379934 X 70762718 76279499 6724729 6695163 77487447 82974662 89366480 89354596 X 11121017 -5458075 -175727 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false true false false true true true false SCHEDULE C, PART II-B, QUESTIONS 1A, 1B, 1D, 1G, & 1H LOBBYING ACTIVITIES: PERIODICALLY, MANAGEMENT AND BOARD MEMBERS WRITE LETTERS AND MAKE PRESENTATIONS ON HEALTH CARE RELATED MATTERS TO EDUCATE ELECTED OFFICIALS AND THE PUBLIC. A DE MINIMIS AMOUNT OF FUNDS ARE SPENT ON THESE ACTIVITIES (LESS THAN $5,000). SCHEDULE C, PART II-B, QUESTION 1I OTHER LOBBYING: THE ORGANIZATION PAYS DUES TO NACHC AND IPHCA AND MEDICATION PROFESSONAL ASSOCIATION. A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES. false 2935884 2935884 34861685 12913823 21947862 6273458 4759636 1513822 2661836 634183 2027653 28425221 Interest in Net Assets of CHF 6549002 Other Receivables 2019900 8568902 54183516 -5458075 -5458075 59641591 146161 146161 59787752 48666735 48666735 48666735 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN 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 XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25 BUT NOT ON LINE 1: $ 146,161 TEMPORARILY RESTRICTED NET ASSETS CONTRIBUTIONS X X X X X false false false false false true false true false LUIS DELGADO VP FINANCE 115104 0 3998 0 126 0 5950 0 29017 0 154195 0 0 0 MARIA CASTILLO-CLAVIJO PHYSICIAN 224364 0 7351 0 283 0 10750 0 27523 0 270271 0 0 0 JITHINRAJ EDAKKANAMBETH VARAYIL PHYSICIAN 184604 0 6362 0 217 0 0 0 22953 0 214136 0 0 0 MANINDER KAUR PHYSICIAN 212615 0 7570 0 247 0 0 0 21676 0 242108 0 0 0 NIVEDITA KARMAKAR PHYSICIAN 219570 0 7377 0 980 0 10690 0 31882 0 270499 0 0 0 VILMA RAMIREZ-FLAMENCO PHYSICIAN 204900 0 7263 0 220 0 0 0 10182 0 222565 0 0 0 SARA ZIBERT PEDIATRICS-DEPTCHAIR END 12/21 258816 0 8704 0 1083 0 12072 0 1371 0 282046 0 0 0 TERRY WHITE COO 216683 0 7214 0 13346 0 10850 0 24281 0 272374 0 0 0 KIMBERLY MILLER FAMILY MEDICINE - DEPT CHAIR 217702 0 6588 0 244 0 10095 0 0 0 234629 0 0 0 ANTOUN AL KHABBAZ WHS - DEPT CHAIR 516788 0 56771 0 1026 0 13050 0 27241 0 614876 0 0 0 SAMUEL MILLER CEO 326279 0 60027 0 13208 0 13050 0 31366 0 443930 0 0 0 SCHEDULE J, PART I, LINE 6A A PORTION OF THE CEO'S PERFORMANCE INCENTIVE WAS BASED ON ACHIEVING CERTAIN FINANCIAL GOALS. SCHEDULE J, PART 1, LINE 7 THE VP FINANCE, COO, AND MEDICAL PROVIDERS WERE GRANTED A BONUS THAT WAS NOT TIED TO ANY PERFORMANCE GOALS. FORM 990, PART 1, LINE 1 ORGANIZATION GENERAL INFORMATION: SINCE 1972, CRUSADER COMMUNITY HEALTH HAS STRIVED TO ENSURE THAT ALL PERSONS IN OUR COMMUNITY HAVE ACCESS TO QUALITY, PRIMARY HEALTH CARE. CRUSADER COMMUNITY HEALTH IS A COMMUNITY-BASED, NOT-FOR-PROFIT CORPORATION, WHOSE MISSION IS TO SERVE THE ROCK RIVER VALLEY WITH QUALITY, PRIMARY HEALTH CARE FOR ALL PEOPLE IN NEED. CRUSADER COMMUNITY HEALTH PLAYS A VITAL HEALTH CARE ROLE IN THIS COMMUNITY, SERVING PATIENTS UNABLE TO AFFORD THE RISING COST OF HEALTH CARE. WHILE THERE ARE NO RESTRICTIONS ON WHO CAN UTILIZE ITS SERVICES, CRUSADER SPECIALIZES IN SERVING MEDICALLY UNDERSERVED INDIVIDUAL - THE HOMELESS, FAMILIES IN POVERTY, HIGH-RISK PREGNANT WOMEN, PERSONS WITH HIV/AIDS, THE ELDERLY AND THOSE WITH CHRONIC DISEASES. WITHOUT CRUSADER, A BROAD AND GROWING SEGMENT OF THE COMMUNITY WOULD FAIL TO RECEIVE THE PRIMARY HEALTH CARE THAT REDUCES THE COST OF CATASTROPHIC ILLNESS. MEDICAL SERVICES ARE PROVIDED ON AN AFFORDABLE SLIDING DISCOUNT BASIS AND INTEGRATE HEALTH PROMOTION AND DISEASE PREVENTION INTO A PROGRAM OF COMPREHENSIVE HEALTH CARE. FORM 990, PART III, LINE 4A MEDICAL SERVICES: PEDIATRICS THE PEDIATRIC DEPARTMENT OFFERS A WIDE RANGE OF SERVICES FOR CHILDREN, INCLUDING CARE FOR NEWBORNS THROUGH ADOLESCENCE. CRUSADER COMMUNITY HEALTH UTILIZES BOARD-CERTIFIED PEDIATRICIANS, FAMILY PRACTITIONERS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS TO DELIVER CARE FOR CHILDREN. SOME OF THE SERVICES AVAILABLE INCLUDE: IMMUNIZATIONS, WELL-CHILD CHECKS, LEAD SCREENING, ATTENTION DEFICIT DISORDER (ADD), ASTHMA EDUCATION AND TREATMENT AND MEDICAL TREATMENT FOR ACUTE CONDITIONS. ADULTS FOR ADULT PATIENTS, CRUSADER PROVIDES PREVENTATIVE CARE AND DIAGNOSIS AND TREATMENT FOR A WIDE RANGE OF ACUTE AND CHRONIC DISEASES. CARE IS DELIVERED THROUGH A TEAM OF BOARD-CERTIFIED MEDICAL PROVIDERS. SOME OF THE SPECIFIC SERVICES AVAILABLE INCLUDE: CHRONIC DISEASE MANAGEMENT, MEDICAL TREATMENT FOR ACUTE CONDITIONS, PHYSICALS, DIABETES EDUCATION AND TREATMENT, HEALTH EDUCATION SERVICES, ASTHMA EDUCATION AND TREATMENT, IMMUNIZATIONS, LABORATORY SERVICES, AND MINOR INJURY CARE. BEHAVIORAL HEALTH SERVICES ARE PROVIDED BY LICENSED CLINICAL SOCIAL WORKERS AND LICENSED CLINICAL PROFESSIONAL COUNSELORS ON-SITE AT EACH OF OUR LOCATIONS. THE BEHAVIORAL HEALTH SPECIALISTS SCHEDULE APPOINTMENTS AND ALSO PLAY AN IMPORTANT ROLE BY BEING EMBEDDED ON THE MEDICAL UNITS TO BE AVAILABLE WHEN A BEHAVIORAL HEALTH ISSUE ARISESDURING ROUTINE MEDICAL APPOINTMENTS. SPECIALTY SERVICES A RANGE OF SPECIALTY SERVICES ARE AVAILABLE TO CRUSADER COMMUNITY HEALTH PATIENTS, SOME OF WHICH INCLUDE: PODIATRY AND INFECTIOUS DISEASE. TO BETTER SERVE OUR PEDIATRIC AND ADULT PATIENTS, CRUSADERS OFFERS WALK-IN CLINICS AT THREE CONVENIENT LOCATIONS, BROADWAY, ALPINE, AND WEST STATE. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES: CRUSADER COMMUNITY HEALTH PROVIDES OTHER PROGRAMS THROUGH ITS ANCILLARY AND COMMUNITY SERVICES AS OUTLINED BELOW. HIV SERVICES SINCE 1991, THE LIVING WITH HIV PROGRAM OF CRUSADER COMMUNITY HEALTH HAS PROVIDED SERVICES TO INDIVIDUALS WITH HIV/AIDS. EMBRACING THE GOAL OF ASSURING CLIENT ACCESS TO MEDICAL CARE, THE PROGRAM ALSO PROVIDES ASSISTANCE WITH TRANSPORTATION, LINKAGE TO SOCIAL SERVICE PROGRAMS, COUNSELING, PSYCHIATRIC SERVICES, AND OBTAINING MEDICATIONS. SERVICES ARE PRIMARILY PROVIDED AT CRUSADER COMMUNITY HEALTH WEST STATE STREET. SERVICES ARE OFFERED CONFIDENTIALLY IN A CARING AND SUPPORTIVE ENVIRONMENT. IN ADDITION TO PROVIDING SERVICES THROUGH ITS PHYSICIAN STAFF, CRUSADER COMMUNITY HEALTH CONTRACTS WITH SWEDISH AMERICAN-INFECTIOUS DISEASE TO PROVIDE ADDITIONAL SUPPORT. OTHER SERVICES OFFERED THROUGH A NURSE PRACTITIONER, PHYSICIAN ASSISTANT, NURSES, CASE MANAGERS AND A LICENSED CLINICAL SOCIAL WORKER. HOMELESS SERVICES CRUSADER COMMUNITY HEALTH'S HEALTH CARE FOR THE HOMELESS PROGRAM WAS ESTABLISHED IN 1988. ITS MISSION IS TO PROVIDE COMPREHENSIVE MEDICAL CARE FOR HOMELESS INDIVIDUALS WITHIN THE ROCKFORD AREA. THE PROGRAM CONSISTS OF PHYSICIANS, DENTISTS, NURSE PRACTITIONERS, NURSES AND CARE MANAGERS COMMITTED TO HELPING CLIENTS ACCESS MEDICAL SERVICES. SERVICES ARE PROVIDED WITHIN CRUSADERS COMMUNITY HEALTH AND AT A VARIETY OF SITES THROUGHOUT THE COMMUNITY. HEALTH EDUCATION THE HEALTH EDUCATION DEPARTMENT OFFERS INTENSIVE CASE MANAGEMENT SERVICES FOR PATIENTS LIVING WITH CHRONIC DISEASES INCLUDING DIABETES, ASTHMA, CONGESTIVE HEART FAILURE (CHF), AND OBESITY (WEIGHT MANAGEMENT). THE DEPARTMENT OFFERS EDUCATION SERVICES IN BOTH A CLASSROOM SETTING AND ONE-TO-ONE SESSIONS IN BOTH ENGLISH AND SPANISH. THE CLINICAL STAFF OF THE PROGRAM IS MADE UP OF HEALTH EDUCATORS. THE DEPARTMENT OFFERS COMMUNITY PROGRAMS THROUGHOUT THE AREA (PRIMARILY WINNEBAGO, BOONE AND STEPHENSON COUNTIES). COMMUNITY SERVICES INCLUDE BLOOD GLUCOSE SCREENINGS FOR DIABETES THROUGH THE COSMOPOLITAN DIABETES PROGRAM AND PUBLIC SPEAKING ENGAGEMENTS ON A VARIETY OF HEALTH-RELATED TOPICS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE FINANCE DEPARTMENT OF THE ORGANIZATION. THE CEO REVIEWS THE FORM 990. A FINAL DRAFT OF THE RETURN IS EMAILED TO ALL BOARD MEMBERS BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST MONITORING: THE CORPORATION PROHIBITS STAFF MEMBERS OR MEMBERS OF THE BOARD OF DIRECTORS FROM USING THEIR POSITION FOR PURPOSES THAT ARE, OR GIVE THE APPEARANCE OF BEING, MOTIVATED BY A DESIRE FOR PRIVATE FINANCIAL GAIN FOR THEMSELVES OR OTHERS WITH WHOM THEY HAVE FAMILY BUSINESS OF OTHER TIES. BOARD MEMBERS AND EXECUTIVE MANAGEMENT DISCLOSE IN WRITING (AND UPDATED YEARLY) ALL BUSINESS AND FAMILY RELATIONSHIPS WHICH MIGHT POTENTIALLY CREATE A CONFLICT. IN ADDITION, THE INDIVIDUAL STAFF MEMBER WITH AN ACTUAL OR POTENTIAL CONFLICT IF PROHIBITED FROM INVOLVEMENT IN THE SELECTION, AWARD AND ADMINISTRATION OF ANY SUCH CONTRACT; A CONFLICTED BOARD MEMBER DISQUALIFIES HIMSELF/HERSELF FROM VOTING AND COMMENTING ON THE CONTRACTOR'S SELECTION AND ANY MONITORING OR OVERSIGHT FUNCTION. FORM 990, PART VI, SECTION B, LINE 15A & B PROCESS FOR DETERMINING COMPENSATION: ANNUALLY THE CEO'S COMPENSATION REVIEW IS CONDUCTED BY THE EXECUTIVE COMMITTEE OF THE BOARD, WITH APPROVAL BY THE FULL BOARD. THE IPHCA, MGMA AND NACHC COMPENSATION SURVEYS ARE USED AS COMPARABILITY DATA. THE PROCESS IS DOCUMENTED IN A REPORT REFERENCED BY THE EXECUTIVE COMMITTEE MINUTES AND THE BOARD MINUTES OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT-OF-INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE DOCUMENTS WOULD BE AVAILABLE FOR VIEWING AT THE ORGANIZATION'S OFFICE. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: ($175,727) DECREASE IN NET ASSETS FOUNDATION