2023-10-30T13:12:57-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2022-01-01 134249732 GOOD NEIGHBOR COMMUNITY HEALTH CENTER GOOD 4025628961 4321 41ST AVENUE COLUMBUS NE 68601 TERRI FORD-WOLFGRAM CEO 4025628961 2023-10-27 1 TERRI FORD-WOLFGRAM 999009999 0 KURT BENNION CPA P01469618 4252506100 2023-10-07 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z TERRI FORD-WOLFGRAM 4321 41ST AVENUE COLUMBUS NE 68601 10940808 0 X WWW.GOODNEIGHBORCOMMUNITYHEALTHCENTER.COM X 2004 NE WORKING TOGETHER WITH THE COMMUNITY TO PROVIDE ACCESS TO QUALITY HEALTHCARE. 12 12 0 12 0 0 5888325 5653098 5547914 5255222 -33758 -29008 4096 22188 11406577 10901500 0 16520 0 0 6567035 6309884 0 0 0 3173156 4072231 9740191 10398635 1666386 502865 3785700 3706932 533266 706629 3252434 3000303 WORKING TOGETHER WITH THE COMMUNITY TO PROVIDE ACCESS TO QUALITY HEALTHCARE. 0 0 8507270 16520 5255222 COLLABORATION WITH FEDERAL, STATE AND COMMUNITY PARTNERS TO PROVIDE AFFORDABLE, COMPREHENSIVE, ACCESSIBLE, CULTURALLY RESPECTFUL, APPROPRIATE, COST-EFFECTIVE, QUALITY PRIMARY MEDICAL HEALTH CARE, DENTAL SERVICES AND BEHAVIORAL HEALTH SERVICES WITH SPECIAL ATTENTION TO THE UNDERSERVED. 8507270 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 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 1 0 0 0 1 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 0 1 1 1 0 1 1 1 1 1 1 1 1 1 0 0 X TERRI FORD-WOLFGRAM 4025628961 4321 41ST AVENUE COLUMBUS NE 68601 TERRI FORD-WOLFGRAM CEO 32.00 8.00 X 0 123077 21675 STEVEN CLARK INTERIM CEO (THROUGH FEB 2022) 32.00 8.00 X 0 66957 117 ED WEMHOFF CHAIR & VICE CHAIR 1.00 1.00 X X 0 0 0 WENDY RAMAEKERS DIRECTOR & CHAIR 1.00 1.00 X X 0 0 0 CONNIE PETERS VICE CHAIR & SECRETARY 1.00 1.00 X X 0 0 0 MICHELLE STEPHAN TREASURER 1.00 0.00 X X 0 0 0 TORIBIO CHAVARRIA DIRECTOR 1.00 0.00 X 0 0 0 TROY FISHER DIRECTOR 1.00 0.00 X 0 0 0 MARIA GONZALEZ DIRECTOR 1.00 0.00 X 0 0 0 RALPH HORACEK DIRECTOR 1.00 1.00 X 0 0 0 STACY LEU DIRECTOR 1.00 0.00 X 0 0 0 DAWN MILLER DIRECTOR 1.00 0.00 X 0 0 0 LIZ RODRIGUEZ DIRECTOR 1.00 0.00 X 0 0 0 MARY STAUB DIRECTOR 1.00 1.00 X 0 0 0 0 190034 21792 0 0 0 0 COMMUNITY LINK CONSULTING INC PO BOX 276 NEWMAN LAKE WA 99025 MEDICAL BILLING & ICFO CONSUTLING 289905 GREENWAY HEALTH PO BOX 203658 DALLAS TX 753203658 SOFTWARE SUPPORT & STAFF TRAINING 236037 ELKHORN WEST CONSTRUCTION 17904 STORAGE ROAD OMAHA NE 68136 CONSTRUCTION 160055 3 5558832 94266 5653098 NET PATIENT SERVICE REVENUE 621400 4683001 4683001 PHARMACY INCOME 456110 572221 572221 5255222 10300 10300 39308 -39308 -39308 -39308 MISCELLANEOUS INCOME 900099 22188 22188 22188 10901500 5255222 0 -6820 16520 16520 5035717 4569151 466566 73977 70035 3942 838027 791289 46738 362163 323229 38934 7722 7722 33740 33740 951265 380300 570965 36842 6547 30295 89769 3852 85917 85731 85731 772801 624832 147969 34655 9664 24991 8669 8669 114022 64960 49062 11546 4939 6607 INDIRECT COST ALLOC. 1018497 1018497 MEDICAL SUPPLIES 663559 612632 50927 OTHER EXPENSES 163481 158 163323 REPAIRS & MAINTENANCE 79932 10665 69267 10398635 8507270 1891365 0 948822 1004185 798446 283473 343409 153652 59 91101 12758 3503665 1250801 1603863 2252864 3785700 3706932 500426 535467 32840 0 171162 533266 706629 X 3252434 3000303 3252434 3000303 3785700 3706932 502865 -754996 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 583116 583116 1433522 123234 1310288 1110682 762524 348158 376345 365043 11302 2252864 DUE TO RELATED ORGANIZATION 171162 171162 10940808 39308 39308 10901500 0 10901500 10067584 812736 812736 9254848 1143787 1143787 10398635 PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS 39,308. PART XII, LINE 2D - OTHER ADJUSTMENTS: CAPITAL OUTLAYS 812,736. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES 11,268. INDIRECT COST RATE ALLOCATION 1,018,497. DEPRECIATION EXPENSE 114,022. 1 TRANSPORTATION ASSISTANCE 1224 16520 COST VEHICLE AND LABOR COSTS PART I, LINE 2: THE ORGANIZATION PROVIDES TRANSPORTATION ASSISTANCE TO CUSTOMERS IN NEED. NO FUNDS ARE GIVEN TO INDIVIDUALS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF GOOD NEIGHBOR COMMUNITY HEALTH CENTER IS EAST-CENTRAL DISTRICT HEALTH DEPARTMENT, A POLITICAL SUBDIVISION OF THE STATE OF NEBRASKA. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS THE POWER TO (A) APPROVE THE ORGANIZATION'S COMMUNITY HEALTH CENTER RENEWAL APPLICATION, ANNUAL BUDGET, BUDGETS FOR OPERATIONS, CAPITAL EXPENDITURES, AND CASH FLOW; (B) REVIEW AND APPROVE THE ORGANIZATION'S SERVICES AND HOURS WHEN SERVICES ARE PROVIDED, LOCATIONS, AND MODE OF DELIVERY; (C) APPROVE THE ORGANIZATION'S MERGER, CONSOLIDATION OR DISSOLUTION; (D) APPROVE ANY CHANGE IN THE ORGANIZATION'S PURPOSE, PHILOSOPHY OR OBJECTIVES; (E) APPROVE THE PURCHASE, SALE, LEASE, TRANSFER OR ENCUMBERANCE OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S PROPERTY; (F) AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; AND (G) APPOINT AND REMOVE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO BEING FILED, THE FORM 990 WAS REVIEWED BY THE CFO AND CEO, WAS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE, AND WAS PROVIDED TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS AND EMPLOYEES. WHEN AN EMPLOYEE HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, THEY NOTIFY THE CEO, WHO DETERMINES WHETHER A CONFLICT EXISTS AND THE APPROPRIATE RESPONSE. WHEN THE CEO OR A BOARD MEMBER HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN REGARDS TO A TRANSACTION, THEY NOTIFY THE BOARD AND PROVIDE RELEVANT INFORMATION, AFTER WHICH THEY LEAVE THE MEETING FOR FURTHER DISCUSSIONS AND VOTES ON THE MATTER. IF IT ISN'T CLEAR WHETHER A CONFLICT EXISTS, THE REMAINING BOARD MEMBERS MAKE THE DETERMINATION. THE BOARD MAY EVALUATE WHETHER THE ORGANIZATION CAN ENTER AN AGREEMENT THAT IS EQUALLY ADVANTAGEOUS TO THE ORGANIZATION AND DOES NOT INVOLVE A CONFLICT OF INTEREST. IF THE BOARD BELIEVES A PERSON HAS FAILED TO IDENTIFY A CONFLICT OF INTEREST, THE INDIVIDUAL IS NOTIFIED AND GIVEN A CHANCE TO RESPOND, AFTER WHICH THE BOARD DETERMINES WHETHER ANY DISCIPLINARY OR CORRECTIVE ACTIONS ARE REQUIRED. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION IS EVALUATED BY THE H.R. DEPARTMENT OF EAST-CENTRAL DISTRICT HEALTH DEPARTMENT, BASED ON MULTIPLE SALARY SURVEYS, WITH A RECOMMENDATION BEING MADE TO EAST-CENTRAL DISTRICT HEALTH DEPARTMENT'S BOARD OF TRUSTEES AND GOOD NEIGHBOR COMMUNITY HEALTH CENTER'S BOARD OF DIRECTORS, WHO THEN REVIEW AND APPROVE THE COMPENSATION RECOMMENDATION. THIS PROCESS IS CONDUCTED ANNUALLY. THE CFO'S COMPENSATION IS EVALUATED BY THE H.R. DEPARTMENT OF EAST-CENTRAL DISTRICT HEALTH DEPARTMENT, BASED ON MULTIPLE SALARY SURVEYS, WITH A RECOMMENDATION BEING MADE TO THE CEO, WHO THEN REVIEWS AND APPROVES THE COMPENSATION RECOMMENDATION. THIS PROCESS IS CONDUCTED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C THE AUTHORITY AND PROCESS OF SELECTING AN INDEPENDENT ACCOUNTANT AND OVERSEEING THE FINANCIAL STATEMENT AUDIT DID NOT CHANGE DURING THE YEAR. EAST-CENTRAL DISTRICT HEALTH DEPARTMENT 4321 41ST AVENUE COLUMBUS NE 68601 470835183 INTER-COUNTY HEALTH DEPARTMENT NE N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0