2023-11-15T11:17:57-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2022-01-01 270052697 UNITED FAMILY PRACTICE HEALTH CENTER UNIT 6517581408 1026 WEST 7TH STREET ST PAUL MN 55102 LORI ZOOK CFO 6517581408 2023-11-15 1 LORI ZOOK 999009999 0 RYAN ENGEBRETSON P01582625 6123764500 2023-11-15 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z UNITED FAMILY MEDICINE DAVE THORSEN 1026 WEST 7TH STREET ST PAUL MN 55102 12112421 0 X WWW.UNITEDFAMILYMEDICINE.ORG X 2003 MN TO PROVIDE CLINICAL HEALTH, BEHAVIORAL HEALTH, DENTAL, AND SUPPORTING SERVICES AS A FQHC TO MEDICALLY UNDERSERVED AND UNDERINSURED PATIENTS. 9 9 168 27 0 0 5408293 5153281 7598729 5798377 65173 9990 1160839 705728 14233034 11667376 0 0 0 0 10606083 10189156 10636 59734 353019 4400088 5074308 15016807 15323198 -783773 -3655822 22572992 18078722 1378433 789144 21194559 17289578 UNITED FAMILY MEDICINE PROVIDES GENERAL PRACTICE PRIMARY CARE, DENTAL, AND MENTAL HEALTH SERVICES TO MEDICALLY UNINSURED AND UNDER INSURED PATIENTS. 0 0 12992989 0 6504105 UFM SERVED MORE THAN 8,400 PATIENTS WITH 29,000 VISITS IN 2022 BY OFFERING PRIMARY MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES. WE EXPANDED OUR DENTAL SERVICES TO RESPOND TO A NEED IN OUR COMMUNITY. WE CONTINUE TO TEST AND TREAT COVID-19 AND HAVE A ROBUST MENTAL HEALTH AND SUBSTANCE ABUSE PROGRAM. 12992989 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 28 0 1 168 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X LORI ZOOK 6517589500 1026 W 7TH ST PAUL MN 55102 JINNY PALEN BOARD CHAIR 2.00 0.00 X X 0 0 0 ZACK RYAN VICE CHAIR 1.00 0.00 X X 0 0 0 KAREN GRIES TREASURER 1.00 0.00 X X 0 0 0 DAVID BAKER SECRETARY 1.00 0.00 X X 0 0 0 WILLIAM SCHULTZ DIRECTOR 1.00 0.00 X 0 0 0 STEPHEN GUMNIT DIRECTOR 1.00 0.00 X 0 0 0 MARIA MACWILLIAMS DIRECTOR 1.00 0.00 X 0 0 0 DAYMOND DEAN DIRECTOR 1.00 0.00 X 0 0 0 HEATHER JAMES DIRECTOR 1.00 0.00 X 0 0 0 RAHCEL DAYTON DIRECTOR 1.00 0.00 X 0 0 0 ANN NYAKUNDI CEO 40.00 0.00 X 164388 0 32951 ERIC BLUM CFO 40.00 0.00 X 30769 0 1213 BERNADETTE QUADLING CMO 32.00 0.00 X 153365 0 897 KEVIN O'BRIEN COO 40.00 0.00 X 91039 0 8301 PHOUNG-GIANG T PHAM DDS 40.00 0.00 X 164804 0 10512 XOUA THAO MD 40.00 0.00 X 229301 0 35943 NATHAN GUIMONT MD 40.00 0.00 X 186638 0 37789 SCOTT TONGEN MD 40.00 0.00 X 225205 0 34430 TEAGAN PRESLEY PA 32.00 0.00 X 113578 0 34671 1359087 0 196707 7 0 1 0 JOHN WHITINGTON 507 THOMAS DRIVE EAGLE LAKE MN 56024 IT SERVICES 184540 COMMUNITY LINK CONSULTING 23905 E WELLESLEY AVE OTIS ORCHARDS WA 99027 FINANCIAL CONSULTING 175164 MAUER COMPANY LLC 320 COUNTY RD D E LITTLE CANADA MN 55117 LANDSCAPING 152620 2 4270132 883149 5153281 PATIENT FEE REVENUE 621110 5798377 5798377 5798377 18860 18860 436175 445045 -8870 -8870 -8870 340B 456110 460035 460035 FUHN IHP GAIN SHARING 624100 245693 245693 705728 11667376 6504105 0 9990 482925 253603 206390 22932 7875973 7024260 708333 143380 227210 197826 24863 4521 951744 828658 104150 18936 651304 567073 71272 12959 78108 78108 96318 15239 81079 59734 59734 507159 245099 257407 4653 90478 53856 7148 29474 152238 90990 61248 664154 619167 38020 6967 514216 395551 103974 14691 7604 5342 2187 75 50822 44389 5044 1389 514332 408292 93565 12475 83832 74624 7673 1535 EQUIPMENT AND SUPPLIES 1337442 1245871 72454 19117 BAD DEBT 603765 603765 INTERPRETER SERVICES 180500 180500 OTHER 115711 61255 54275 181 77629 77629 15323198 12992989 1977190 353019 655242 34576 9593438 5579792 24571 0 562900 657155 34231 37251 14917551 4905919 8688671 10011632 1367395 1156343 1646544 601973 22572992 18078722 942847 616500 435586 0 172644 1378433 789144 X 20153947 16232555 1040612 1057023 21194559 17289578 22572992 18078722 -3655822 -249159 0 X 0 1 X 1 1 1 X 3658724 3131447 3225793 5152444 5153281 20321689 12110078 12405839 10368906 7598729 5798377 48281929 1991405 1950744 2768188 1160839 705728 8576904 17760207 17488030 16362887 13912012 11657386 77180522 8391 3658 2903 959 1550 17461 1647243 1599286 1655669 835706 343273 6081177 1655634 1602944 1658572 836665 344823 6098638 71081884 5382 84849 44917 46654 18860 200662 5382 84849 44917 46654 18860 200662 17765589 17572879 16407804 13958666 11676246 77381184 0.91860 0.90750 0.00260 0.00250 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1040612 16411 1057023 1040612 1040612 1015378 25234 1040612 928272 87106 1015378 148374 779898 928272 1.00000 0.00000 0.00000 0 0 2464157 2464157 9187752 4236573 4951179 256776 14088 242688 976067 500056 476011 2032799 155202 1877597 10011632 OPERATING LEASE LIABILITY 172644 172644 X 10286365 -249159 -603765 -852924 11139289 528087 528087 11667376 14719433 0 14719433 603765 603765 15323198 PART V, LINE 4: THE ENDOWMENT CONSIST OF ONE FUND USED TO SUPPORT THE HEALTH CENTER. THE FUNDS ARE TO BE USED FOR FUTURE CAPITAL IMPROVEMENTS OR PROJECTS OVER WHICH THE BOARD RETAINS CONTROL AND MAY, AT ITS DISCRETION, SUBSEQUENTLY USE FOR OTHER PURPOSES. PART X, LINE 2: THE HEALTH CENTER QUALIFIES AS A TAX-EXEMPT CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). ACCORDINGLY, THE HEALTH CENTER IS NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE IRC. THE HEALTH CENTER IS CLASSIFIED AS A PUBLICLY SUPPORTED CHARITABLE ORGANIZATION UNDER SECTION 509(A)(2) OF THE IRC AND CONTRIBUTIONS TO THE HEALTH CENTER QUALIFY AS A CHARITABLE TAX DEDUCTION BY THE CONTRIBUTOR. THE HEALTH CENTER HAS ELECTED TO ADOPT GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE HEALTH CENTER FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -603,765. PART XI, LINE 4B - OTHER ADJUSTMENTS: CAPITAL AND RESTRICTED GRANTS AND CONTRIBUTIONS 528,087. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 603,765. X X 1 J MURPHY ASSOCIATES 4407 29TH AVE SOUTH MINNEAPOLIS MN 55406 GRANT WRITER 0 0 59734 -59734 59734 -59734 MN X X 0 0 0 0 0 0 0 0 0 XOUA THAO MD 229301 0 0 0 0 0 0 0 35943 0 265244 0 0 0 SCOTT TONGEN MD 224205 0 1000 0 0 0 10795 0 23635 0 259635 0 0 0 NATHAN GUIMONT MD 186638 0 0 0 0 0 9492 0 28297 0 224427 0 0 0 ANN NYAKUNDI CEO 164388 0 0 0 0 0 0 0 32951 0 197339 0 0 0 PHOUNG-GIANG T PHAM DDS 164804 0 0 0 0 0 8393 0 2119 0 175316 0 0 0 BERNADETTE QUADLING CMO 153365 0 0 0 0 0 0 0 897 0 154262 0 0 0 FORM 990, PART VI, SECTION A, LINE 1A MEMBERS OF THE COMMITTEE SHALL ACT FOR THE CORPORATION IN ALL MATTERS DURING THE INTERIM PERIODS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. ACTIONS TAKEN BY THE EXECUTIVE/FINANCE COMMITTEE SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD, AND ALL MATTERS OF MAJOR IMPORTANCE SHALL BE REFERRED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PRESENTED TO THE FINANCE COMMITTEE WHO REVIEWS IN DETAILS. IT IS PROVIDED TO ALL BOARD MEMBERS WITH FINAL APPROVAL BEING VOTED ON AT A BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS CONSISTS OF INDEPENDENT PERSONS ESTABLISHES GOALS AND OBJECTIVES FOR THE BOARD OF DIRECTORS AND ANY POTENTIAL CONFLICTS OF INTEREST THAT MAY OCCUR DURING THEIR MEMBERSHIP ON THE BOARD OF DIRECTORS. EACH YEAR, THE BOARD OF DIRECTORS REVIEWS CONFLICTS OF INTEREST WITH LEGAL COUNSEL. APPROPRIATE EDUCATION AND/OR ACTIONS ARE TAKEN BY THE BOARD AS NEEDED IN ACCORDANCE WITH THE CORPORATION'S CONFLICT OF INTEREST POLICY. BOARD MEMBERS ARE REQUIRED TO DISCLOSE AT A BOARD MEETING PREVIOUSLY UNDISCLOSED CONFLICTS AND REFRAIN FROM PARTICIPATION IN DISCUSSION OR VOTING ON THE CONFLICTING SUBJECT. KEY EMPLOYEES OF THE ORGANIZATION ARE REQUIRED TO SIGN A CONFLICT OF INTEREST DISCLOSURE ANNUALLY AS PART OF THE ORGANIZATION POLICIES FOR EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS, WHICH CONSIST OF INDEPENDENT PERSONS ESTABLISHES GOALS AND OBJECTIVES FOR THE CEO AND WITH THE ASSISTANCE OF THE HR DIRECTOR OF UFM WILL COMPILE MARKET SALARY SURVEY RESEARCH ANALYSIS AND REVIEW THIS DATA AS PART OF ONGOING CEO COMPENSATION. THIS DATA INCLUDES SOURNCES SUCH AS MNACHC SURVEY AND MN COUNCIL OF NON PROFITS FOR LIKE POSITIONS. THE BOARD, OR COMMITTEE OF THE BOARD WILL DOCUMENT FINDINGS AND ANALYSIS RELATED TO THE MARKET ANALYSIS. COMPENSATION IS REVIEWED FOR EQUITY INTERNALLY WITH HR DIRECTOR PROCESSES AND PROCEDURES. EXTERNAL COMPENSATION REVIEW IS DONE BY HR DIRECTOR USING MNACHC SURVEY, SMALL PRACTICE COMPENSATION SURVEY, AND FAIRVIEW SALARY SURVEY AS COMPENSATION RESOURCES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVILABLE TO THE PUBLIC UPON WRITTEN REQUEST TO THE CEO OR CFO.