2024-11-15T16:38:06-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2023-01-01 237167576 LAKE SUPERIOR COMMUNITY HEALTH CENTER LAKE 2187221497 4325 GRAND AVE DULUTH MN 55807 LEE HOMAN CEO 2187221497 2024-11-14 1 0 RYAN ENGEBRETSON P01585625 6123764500 2024-11-14 2023 2024-10-15 13:58:12Z LEE HOMAN 4325 GRAND AVE DULUTH MN 55807 14383732 0 X WWW.LSCHC.ORG X 1972 MN AS A COMMUNITY HEALTH CENTER, WE ARE DEDICATED TO PROVIDING CARE TO EVERYONE IN NEED, REGARDLESS OF INSURANCE OR ABILITY TO PAY.WE SEEK TO IMPROVE ACCESS TO QUALITY HEALTH CARE FOR ALL BY PROVIDING ACCESS TO QUALITY MEDICAL, DENTAL, AND BEHAVIORAL HEALTH CARE. DELIVERING COMPREHENSIVE, INTEGRATED AND COST-EFFECTIVE CARE AND STRIVE TO CREATE A BETTER WORLD BY GUIDING INDIVIDUALS, FAMILIES AND COMMUNITIES TO IMPROVED HEALTH AND WELL-BEING. 12 12 140 15 0 0 5115599 3502144 9333410 10621971 -139771 242465 16008 17152 14325246 14383732 0 0 0 0 8712019 9654609 0 0 9419 4562004 5219714 13274023 14874323 1051223 -490591 17499366 16297777 6910112 6260989 10589254 10036788 X TO IMPROVE ACCESS TO QUALITY HEALTH CARE FOR ALL. 0 0 5419700 0 5117904 DENTAL - LAKE SUPERIOR COMMUNITY HEALTH CENTER PROVIDES PRIMARY DENTAL CARE FOR LOW INCOME UNINSURED, UNDERINSURED, AND PUBLIC PROGRAM ENROLLED COMMUNITY MEMBERS. THIS CARE INCLUDES OFFICE EXAMINATIONS, CLEANINGS, FLUORIDE TREATMENTS, X-RAYS, SEALANTS, RESTORATION, ROUTINE EXTRACTIONS, PARTIALS, DENTURES, ROOT CANALS, AND CROWNS. IN 2023, THE CENTER SERVED 7,620 PATIENTS WITH 16,958 VISITS. 4264997 0 4027500 MEDICAL - LAKE SUPERIOR COMMUNITY HEALTH CENTER PROVIDES PRIMARY CLINICAL MEDICAL CARE FOR LOW INCOME UNINSURED, UNDERINSURED AND PUBLIC PROGRAM ENROLLED COMMUNITY MEMBERS. THIS CARE INCLUDES ACUTE CARE, MANAGEMENT OR CHRONIC DISEASE, PREVENTATIVE CARE, ASSISTED REFERRALS, CHIROPRACTIC SERVICES AND MENTAL HEALTH COUNSELING. IN 2023, THE CENTER SERVED 4,713 PATIENTS WITH 18,843 IN-PERSON VISITS AND 1,169 VIRTUAL VISITS.ITH 16,958 VISITS. 598334 0 565016 MEDICAL SOCIAL WORK & ALCOHOL AND OTHER DRUG ABUSE - LAKE SUPERIOR COMMUNITY HEALTH CENTER PROVIDES MEDICAL SOCIAL WORK SERVICES FOR LOW INCOME COMMUNITY MEMBERS. THESE SERVICES INCLUDE ELIGIBILITY SCREENING, APPLICATION ASSISTANCE, AND ADVOCACY FOR THOSE SEEKING ENROLLMENT IN PUBLIC HEALTH COVERAGE PROGRAMS SERVICES ALSO INCLUDE BASIC SOCIAL WORK ASSISTANCE SUCH AS COUNSELING, ADVOCACY, AND ASSISTED REFERRALS. IN 2022, THE CENTER SERVED 329 PATIENTS WITH 2,323 IN-PERSON VISITS AND 2,882 VIRTUAL VISITS IN BEHAVIORAL HEALTH AND 154 PATIENTS WITH 1,409 IN-PERSON VISITS IN AND 83 VIRTUAL VISITS IN SUBSTANCE USE DISORDER. 965304 0 911551 HEALTH CARE ACCESS OFFICE, INTEGRATED CARE COORDINATION, 340B PHARMACYPROGRAM 965304 0 911551 11248335 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 58 0 1 140 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 1 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN WI X JAKE KUSCHKE 7153955386 2222 EAST 5TH STREET SUPERIOR WI 54880 KIM TERHAAR BOARD VICE CHAIR 2.00 X X 315 0 0 BOB LYMAN BOARD CHAIR 2.00 X X 0 0 0 SONYA ALSTONE BOARD MEMBER 2.00 X 0 0 0 JEDEDIAH JANSON BOARD MEMBER 2.00 X 0 0 0 CHRIS RUSS BOARD MEMBER (THRU DECEMBER) 2.00 X 0 0 0 DIANE HOLLIDAY-WELSH BOARD SECRETARY 2.00 X X 0 0 0 DYANI BRADDICK BOARD MEMBER 2.00 X 420 0 0 CINDY CAPIN BOARD MEMBER 2.00 X 0 0 0 TIMOTHY AUSMAN BOARD MEMBER 2.00 X 210 0 0 HOLLY COMPO BOARD MEMBER 2.00 X 0 0 0 KYLE DICKINSON BOARD TREASURER 2.00 X X 140 0 0 ASHLEY LUNA BOARD MEMBER 2.00 X 245 0 0 COURTNEY KOSTREBA BOARD MEMBER 2.00 X 0 0 0 HEATHER MICHALES BOARD DIRECTOR (THRU MAY) 2.00 X 0 0 0 JESSIE PETERSON CEO 40.00 X 144633 0 16600 KATRINA JAWORSKI CFO 40.00 X 89755 0 13818 LEE HOMAN CEO 40.00 X 88578 0 27329 CRYSTAL MEYER CHRO 40.00 X 99576 0 1243 EMILY ANDERSON PHYSICIAN / MEDICAL DIRECTOR 36.00 X 240078 0 26054 JACOB OESTREICH PHYSICIAN 32.00 X 179414 0 33089 YIN CAO DDS / DENTAL DIRECTOR 40.00 X 197978 0 18212 RICHARD DEVORAK DDS 40.00 X 178957 0 11571 KARA MCGILLIVRAY CHIRO DIRECTOR/CHIROPRACTOR 30.00 X 149598 0 32057 1369897 0 179973 18 0 1 0 BARTON ASSOCIATES INC 300 JUBILEE DRIVE PEABODY MA 01960 HEALTHCARE STAFFING 393150 THE BOLDT COMPANY 1001 TALL PINE LANE CLOQUET MN 55720 CONSTRUCTION MANAGEMENT 377807 BREAKWATER HEALTH NETWORK 1346 W ARROWHEAD RD DULUTH MN 55811 NETWORK HOSTING 358998 TRI STATE LABS PO BOX 1148 SUPERIOR WI 54880 LAB SERVICES 140001 SERVICE MASTERS 3 163RD AVE W DULUTH MN 55807 CLEANING SERVICE 116400 6 25873 3200854 275417 3502144 DENTAL SERVICE REVENUE 621300 5117904 5117904 MEDICAL SERVICE REVENUE 621110 4027500 4027500 340B PROGRAM REVENUE 456110 848727 848727 BEHAVIORAL HEALTH REVENUE 621110 565016 565016 HEALTH CARE ACCESS OFFICE 624100 62824 62824 10621971 234333 234333 8132 0 8132 8132 8132 MISCELLANEOUS REVENUE 900099 17152 17152 17152 14383732 10621971 0 259617 468490 468490 7079390 6151449 920549 7392 196948 159081 37676 191 1327251 1072065 253899 1287 582530 474626 107355 549 5998 5998 128410 128410 1800 1800 13953 13953 809151 695717 113434 45231 25210 20021 391680 212195 179485 413306 7632 405674 835942 416779 419163 56105 46019 10086 28238 20616 7622 367419 286205 81214 80638 684 79954 340B CONTRACT FEES 682606 679474 3132 MEDICAL SUPPLIES 397539 376345 21194 BAD DEBT 386045 386045 REPAIRS & MAINTENANCE 345404 107687 237717 230249 130506 99743 14874323 11248335 3616569 9419 1100 1000 6987657 4977656 1251424 611852 485395 511314 120319 164751 12820991 5592032 7816842 7228959 745753 2450199 90876 352046 17499366 16297777 1129765 1049682 18884 148766 141866 5631581 5050557 6910112 6260989 X 10489254 10036788 100000 0 10589254 10036788 17499366 16297777 X -490591 38125 -100000 X X 0 1 X 1 1 1 X 2842836 4644922 4325742 5115599 3502144 20431243 2842836 4644922 4325742 5115599 3502144 20431243 214919 20216324 39084 18564 527 13129 234333 305637 17152 17152 20754032 44180142 0.97410 0.97610 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1800 1800 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE WISCONSIN PRIMARY HEALTH CARE ASSOCIATION (WPHCA) AND THE MINNESOTA ASSOCIATION OF COMMUNITY HEALTH CENTERS (MNACHC). A PART OF THE MEMBERSHIP DUES PAID TO THESE ORGANIZATIONS IS FOR LOBBYING EXPENDITURES. THE ORGANIZATIONS IN THEIR RESPECTIVE STATES ADVOCATE TO ENSURE THAT THE VOICE OF THEIR MEMBERS AND THEIR PATIENTS ARE HEARD LEGISLATIVELY IN ADDITION TO THE MANY OTHER NON-LOBBYING BENEFITS PROVIDED. 50000 50000 9092884 2762385 6330499 79044 21111 57933 3599063 2808536 790527 7228959 LEASE LIABILITY 5050557 5050557 14021859 38125 38125 13983734 13953 386045 399998 14383732 14474325 0 14474325 13953 386045 399998 14874323 PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 386,045. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 386,045. X X 0 0 0 0 0 0 0 0 0 EMILY ANDERSON PHYSICIAN / MEDICAL DIRECTOR 238310 0 1768 0 0 0 11250 0 14804 0 266132 0 0 0 YIN CAO DDS / DENTAL DIRECTOR 168336 0 29642 0 0 0 6689 0 11523 0 216190 0 0 0 JACOB OESTREICH PHYSICIAN 177267 0 2147 0 0 0 7029 0 26060 0 212503 0 0 0 RICHARD DEVORAK DDS 177465 0 1492 0 0 0 0 0 11571 0 190528 0 0 0 KARA MCGILLIVRAY CHIRO DIRECTOR/CHIROPRACTOR 149133 0 465 0 0 0 7890 0 24167 0 181655 0 0 0 JESSIE PETERSON CEO 144633 0 0 0 0 0 7263 0 9337 0 161233 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION OUTSOURCED CFO DUTIES TO WIPFLI AT THE END OF 2023 WITH THE DEPARTURE OF KATRINA JAWORSKI, FORMER CFO. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE UPDATED IN THE CONFLICT OF INTEREST POLICY TO INCLUDE LANGUAGE ADDITIONS TO CLARIFY WHO IS CONSIDERED FAMILY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO AND DIRECTOR OF FINANCE. FOLLOWING THEIR REVIEW, IT IS REVIEWED BY THE FINANCE COMMITTEE WHICH MAKES A RECOMMENDATION TO THE FULL BOARD OF DIRECTORS TO APPROVE. THE BOARD OF DIRECTORS ISSUE FINAL APPROVAL PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATIONS'S BOARD OF DIRECTORS CONDUCT AN ANNUAL REVIEW AND DECLARATION OF THE CONFLICT OF INTEREST POLICY. AT THE TIME OF A CONFLICT, THE INTERESTED DIRECTOR MUST FULLY DISCLOSE TO THE REST OF THE BOARD OF DIRECTORS ANY POTENTIAL CONFLICT OF INTEREST. THE REMAINING BOARD OF DIRECTORS THEN AUTHORIZE, APPROVE, OR RATIFY THE CONTRACT OR TRANSACTION IN GOOD FAITH BY THE AFFIRMATIVE VOTE OF A MAJORITY OF THE DIRECTORS (WITHOUT INCLUDING THE INTERESTED DIRECTOR) AT A MEETING WHICH THERE IS A QUORUM WITHOUT COUNTING THE INTERESTED DIRECTOR. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION REVIEWS MARKET DATA AND SALARY SURVEYS ON AN ANNUAL BASIS. THIS DATA IS REVIEWED BY THE EXECUTIVE TEAM AND WAGE DECISIONS FOR THE UPCOMING YEAR ARE MADE AS PART OF THE BOARDS APPROVAL OF THE ANNUAL BUDGET. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND STATEMENTS AVAILABLE UPON REQUEST AT THE CENTER'S ADMINISTRATIVE OFFICES IN DULUTH, MN. FORM 990, PART XI, LINE 9: RELEASED FROM RESTRICTION -100,000. FORM 990, PART XII, LINE 2C: THE PROCESS FOR SELECTION AND OVERSIGHT OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.