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Nonprofiteer
← LAKE SUPERIOR COMMUNITY HEALTH CENTER

Form 990 for tax year 2022

Filed by LAKE SUPERIOR COMMUNITY HEALTH CENTER.

Totals

Total revenue
$14,325,246
Total expenses
$13,274,023
Contributions and grants received
$5,115,599
Grants paid
$0
Program service revenue
$9,333,410
Investment income
-$139,771
Other revenue
$16,008
Total assets, end of year
$17,499,366
Total liabilities, end of year
$6,910,112
Net assets or fund balances, end of year
$10,589,254
Program services expenses (Part IX)
$9,658,972
Management and general expenses
$3,605,759
Fundraising expenses
$9,292
Program service expenses (Part III)
$9,658,972

Program services were 72.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1a · Federated campaigns

    $33,702

  • 1e · Government grants (contributions)

    $4,829,256

  • 1f · All other contributions, gifts and grants

    $252,641

  • 2a · Program service revenue: DENTAL SERVICE REVENUE

    total $4,649,320 · related or exempt $4,649,320

  • 2b · Program service revenue: MEDICAL SERVICE REVENUE

    total $3,181,206 · related or exempt $3,181,206

  • 2c · Program service revenue: BEHAVIORAL HEALTH REVENUE

    total $767,763 · related or exempt $767,763

  • 2d · Program service revenue: 340B PROGRAM REVENUE

    total $708,521 · related or exempt $708,521

  • 2e · Program service revenue: HEALTH CARE ACCESS OFFICE

    total $26,600 · related or exempt $26,600

  • 3 · Investment income

    total $13,129 · excluded $13,129

  • 7b · Less cost or other basis and sales expenses

    other assets $152,900

  • 7c · Gain or loss

    other assets -$152,900

  • 7d · Net gain or loss

    total -$152,900 · excluded -$152,900

  • 11a · Other revenue: MISCELLANEOUS REVENUE

    total $16,008 · excluded $16,008

  • 11e · Other revenue, total

    $16,008

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $489,605 · management and general $489,605

  • 7 · Other salaries and wages

    total $6,613,356 · program services $5,689,657 · management and general $916,402 · fundraising $7,297

  • 8 · Pension plan contributions

    total $182,995 · program services $153,138 · management and general $29,603 · fundraising $254

  • 9 · Other employee benefits

    total $868,669 · program services $726,942 · management and general $140,522 · fundraising $1,205

  • 10 · Payroll taxes

    total $557,394 · program services $446,362 · management and general $110,496 · fundraising $536

  • 11b · Fees: legal

    total $34,318 · management and general $34,318

  • 11c · Fees: accounting

    total $45,925 · management and general $45,925

  • 11d · Fees: lobbying

    total $1,055 · management and general $1,055

  • 11f · Fees: investment management

    total $2,593 · management and general $2,593

  • 11g · Fees: other

    total $580,684 · program services $409,649 · management and general $171,035

  • 12 · Advertising and promotion

    total $64,964 · program services $27,878 · management and general $37,086

  • 13 · Office expenses

    total $588,730 · program services $233,934 · management and general $354,796

  • 14 · Information technology

    total $368,863 · program services $21,715 · management and general $347,148

  • 16 · Occupancy

    total $793,738 · program services $381,743 · management and general $411,995

  • 17 · Travel

    total $21,318 · program services $13,715 · management and general $7,603

  • 19 · Conferences, conventions and meetings

    total $25,464 · program services $17,612 · management and general $7,852

  • 22 · Depreciation, depletion and amortization

    total $345,608 · program services $253,390 · management and general $92,218

  • 23 · Insurance

    total $66,169 · program services $1,608 · management and general $64,561

  • 24a · Other expenses: 340B CONTRACT FEES

    total $391,437 · program services $391,100 · management and general $337

  • 24b · Other expenses: REPAIRS & MAINTENANCE

    total $359,793 · program services $124,448 · management and general $235,345

  • 24c · Other expenses: MEDICAL SUPPLIES

    total $330,774 · program services $322,205 · management and general $8,569

  • 24d · Other expenses: BAD DEBT

    total $303,288 · program services $303,288

  • 24e · All other expenses

    total $237,283 · program services $140,588 · management and general $96,695

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,100 · end of year $1,100

  • 2 · Savings and temporary cash investments

    beginning of year $7,858,897 · end of year $6,987,657

  • 3 · Pledges and grants receivable

    beginning of year $354,988 · end of year $1,251,424

  • 4 · Accounts receivable

    beginning of year $617,874 · end of year $485,395

  • 9 · Prepaid expenses and deferred charges

    beginning of year $60,110 · end of year $120,319

  • 10a · Land, buildings and equipment: cost or other basis

    $11,900,044

  • 10b · Land, buildings and equipment: accumulated depreciation

    $4,083,202

  • 10c · Land, buildings and equipment, net

    beginning of year $2,024,375 · end of year $7,816,842

  • 11 · Investments: publicly traded securities

    end of year $745,753

  • 15 · Other assets

    beginning of year $0 · end of year $90,876

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,219,207 · end of year $1,129,765

  • 19 · Deferred revenue

    beginning of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $155,628 · end of year $148,766

  • 25 · Other liabilities

    beginning of year $0 · end of year $5,631,581

  • 27 · Net assets without donor restrictions

    beginning of year $9,442,509 · end of year $10,489,254

  • 28 · Net assets with donor restrictions

    beginning of year $100,000 · end of year $100,000

Mission and programs · 2022

Mission

TO IMPROVE ACCESS TO QUALITY HEALTH CARE FOR ALL.

Activities or mission (Part I)

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.

  • 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 2022, THE CENTER SERVED 7,172 PATIENTS WITH 15,895 VISITS.

    Expenses $4,811,495 · Revenue $4,649,320

  • 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 AND MENTAL HEALTH COUNSELING. IN 2022, THE CENTER SERVED 3,283 PATIENTS WITH 9,622 IN-PERSON VISITS AND 1,637 VIRTUAL VISITS.

    Expenses $3,292,171 · Revenue $3,181,206

  • 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 388 PATIENTS WITH 2,371 IN-PERSON VISITS AND 3,498 VIRTUAL VISITS IN BEHAVIORAL HEALTH AND 145 PATIENTS WITH 866 IN-PERSON VISITS IN AND 154 VIRTUAL VISITS IN SUBSTANCE USE DISORDER.

    Expenses $794,544 · Revenue $767,763

  • HEALTH CARE ACCESS OFFICE, INTEGRATED CARE COORDINATION, 340B PHARMACYPROGRAM

    Expenses $760,762 · Revenue $735,121

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Kim Terhaar

    SECRETARY

    Total calculated
    $210
    From this org
    $210
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Bob Lyman

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • Shelly Marquardt

    CHAIR

    Total calculated
    $0
    Hours/week
    1

  • Alecia McKay-Jones

    TREASURER

    Total calculated
    $0
    Hours/week
    1

  • Sonya Alstone

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Alison Gondik

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Princess Kisob

    DIRECTOR

    Total calculated
    $280
    From this org
    $280
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Jedediah Janson

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Chris Rus

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Diane Holliday-Welsh

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Dyani Braddick

    DIRECTOR

    Total calculated
    $280
    From this org
    $280
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Cindy Capin

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Timothy Ausman

    DIRECTOR

    Total calculated
    $175
    From this org
    $175
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Heather Michaels

    DIRECTOR

    Total calculated
    $315
    From this org
    $315
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Holly Compo

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Amy Lowindowksi

    DIRECTOR (THRU 3/22)

    Total calculated
    $0
    Hours/week
    1

  • Jessie Peterson

    CEO

    Total calculated
    $159,603
    From this org
    $139,132
    From related orgs
    $0
    Other
    $20,471
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $138,820
    Bonus
    $312
    Other
    $0
    Deferred
    $6,750
    Nontaxable benefits
    $13,721
    Filer's total
    $159,603

  • Katrina Jaworski

    CFO

    Total calculated
    $108,908
    From this org
    $95,394
    From related orgs
    $0
    Other
    $13,514
    Hours/week
    40

  • Lee Homan

    COO

    Total calculated
    $124,278
    From this org
    $86,672
    From related orgs
    $0
    Other
    $37,606
    Hours/week
    40

  • Crystal Meyer

    CHRO

    Total calculated
    $102,305
    From this org
    $100,591
    From related orgs
    $0
    Other
    $1,714
    Hours/week
    40

  • Emily Anderson

    PHYSICIAN / MEDICAL DIRECTOR

    Total calculated
    $263,874
    From this org
    $235,011
    From related orgs
    $0
    Other
    $28,863
    Hours/week
    36

    Schedule J breakdown matched by us

    Base
    $233,549
    Bonus
    $1,462
    Other
    $0
    Deferred
    $10,250
    Nontaxable benefits
    $18,613
    Filer's total
    $263,874

  • Jacob Oestreich

    PHYSICIAN

    Total calculated
    $218,804
    From this org
    $174,117
    From related orgs
    $0
    Other
    $44,687
    Hours/week
    32

    Schedule J breakdown matched by us

    Base
    $172,818
    Bonus
    $1,299
    Other
    $0
    Deferred
    $10,250
    Nontaxable benefits
    $34,437
    Filer's total
    $218,804

  • Jeffrey Bertani

    DDS

    Total calculated
    $194,546
    From this org
    $176,245
    From related orgs
    $0
    Other
    $18,301
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $170,321
    Bonus
    $5,924
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $18,301
    Filer's total
    $194,546

  • Prabhjot Arrora

    DDS/DENTAL DIRECTOR

    Total calculated
    $204,407
    From this org
    $179,976
    From related orgs
    $0
    Other
    $24,431
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $178,893
    Bonus
    $1,083
    Other
    $0
    Deferred
    $10,250
    Nontaxable benefits
    $14,181
    Filer's total
    $204,407

  • Yin Cao

    DDS

    Total calculated
    $213,487
    From this org
    $192,161
    From related orgs
    $0
    Other
    $21,326
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $125,337
    Bonus
    $66,824
    Other
    $0
    Deferred
    $7,061
    Nontaxable benefits
    $14,265
    Filer's total
    $213,487

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Provenance

Return type
form_990
Tax year
2022
Filed
2 October 2023
IRS schema version
2022v5.0
Source object
202312769349301266

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