2023-10-09T11:57:51-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2022-01-01 043634356 BOUNDARY REGIONAL HEALTH CENTER INC BOUN 2082678422 301 CEDAR STREET 206 SANDPOINT ID 83864 EMMA KEVERKAMP CFO 2082678422 2023-10-07 1 EMMA KEVERKAMP 999009999 1 KURT BENNION CPA P01469618 4252506100 2023-10-07 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z KANIKSU COMMUNITY HEALTH KEVIN KNEPPER 301 CEDAR STREET 206 SANDPOINT ID 83864 18392446 0 X WWW.KCHNORTHIDAHO.ORG X 2002 ID TO PROVIDE HIGH QUALITY, COST EFFECTIVE, CULTURALLY SENSITIVE HEALTH CARE SERVICES. 12 12 209 12 0 0 6046045 5536771 12030254 12094445 0 0 457449 761230 18533748 18392446 7838 4849 0 0 11953079 11968619 0 540 540 4840905 5550834 16801822 17524842 1731926 867604 17102347 19145223 11661296 12836568 5441051 6308655 X THE MISSION OF KANIKSU COMMUNITY HEALTH IS TO PROVIDE HIGH QUALITY, COST EFFECTIVE, CULTURALLY SENSITIVE HEALTH CARE SERVICES. 0 0 6233599 4849 5954095 KANIKSU COMMUNITY HEALTH (CENTER) PROVIDED MEDICAL VISITS TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED MEDICAL ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 2405817 0 2297945 KANIKSU COMMUNITY HEALTH (CENTER) PROVIDED PEDIATRIC MEDICAL VISITS TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED PEDIATRIC CARE REGARDLESS OF A PERSON'S ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 2186761 0 2088711 KANIKSU COMMUNITY HEALTH (CENTER) PROVIDED DENTAL VISITS TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED DENTAL ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 933204 0 891361 KANIKSU COMMUNITY HEALTH (CENTER) PROVIDED BEHAVIORAL HEALTH SERVICES TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED BEHAVIORAL HEALTH ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. 902815 0 862333 KANIKSU COMMUNITY HEALTH (CENTER) OPENED AN IN-HOUSE PHARMACY IN 2022. THIS SERVICE WAS AVAILABLE TO ANY PATIENT IN BOUNDARY AND BONNER COUNTIES. THE PHARMACY UTILIZES A SLIDING FEE SCHEDULE UP TO 400% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF THEIR CHARGES MAY BE REDUCED TO A NOMINAL DISPENSING FEE PLUS COST OF MEDICATION. 0 0 0 KANIKSU COMMUNITY HEALTH CONTINUED AS A KEY PLAYER IN THE FIGHT AGAINST THE CORONAVIRUS PANDEMIC IN 2022. WE CONTINUED TO WORK WITH LOCAL GOVERNMENT AGENCIES AND COMMUNITY PARTNERS TO PLAN AND IMPLEMENT COMMUNITY WIDE PREVENTION STRATEGIES AND TACTICS. WE WERE ONE OF A FEW ORGANIZATIONS WITHIN OUR AREA TO OFFER COVID-19 VACCINATIONS. WE WORKED WITH COMMUNITY PARTNERS TO IMPLEMENT VACCINE CLINICS FOR OUR COMMUNITY IN THE FIGHT AGAINST COVID. 1836019 0 1753694 12662196 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 23 0 209 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X EMMA KEVERKAMP 2082637101 301 CEDAR STREET 206 SANDPOINT ID 83864 ADAM WEAVER DENTAL CHIEF 36.00 X 209610 0 22596 KEVIN KNEPPER CEO 40.00 X 200999 0 27000 BEN STOCKTON FAMILY PRACTICE PHYSICIAN 40.00 X 195434 0 26611 GEORGE DELAND PEDIATRICIAN 36.00 X 207438 0 13048 NICK MILLER DENTIST 40.00 X 195111 0 14411 FELICIA LUCAS FAMILY PRACTICE PHYSICIAN 36.00 X 193752 0 10048 HAILEY ROSE PEDIATRICIAN 40.00 X 186398 0 14012 AMBER VILLELLI COO 40.00 X 145078 0 11664 EMMA KEVERKAMP CFO 40.00 X 103449 0 6207 SHEILA FARMIN-AUMICK CHAIR 2.00 X X 0 0 0 JOY JANSEN PHD VICE CHAIR 2.00 X X 0 0 0 ASHLEY WENDLAND SECRETARY 2.00 X X 0 0 0 MATTHEW WILLIAMS TREASURER 2.00 X X 0 0 0 JOE ENGLISH DIRECTOR 2.00 X 0 0 0 PEGGY FRYE DIRECTOR 2.00 X 0 0 0 DEBORAH KERR DIRECTOR 2.00 X 0 0 0 JOSH LEONARD DIRECTOR 2.00 X 0 0 0 KATE MCALLISTER DIRECTOR 2.00 X 0 0 0 MARY READER DIRECTOR 2.00 X 0 0 0 KARI SNYDER DIRECTOR 2.00 X 0 0 0 RON STULTZ DIRECTOR 2.00 X 0 0 0 1637269 0 145597 22 0 1 0 NORTH IDAHO FAMILY PHYSICIANS 8836 N HESS STREET SUITE B HAYDEN ID 83835 BILLING SERVICES 706264 KOOTENAI HEALTH 2003 KOOTENAI HEALTH WAY COEUR DALENE ID 83814 SOFTWARE SUPPORT 152253 CURATIVE TALENT LLC PO BOX 122549 DALLAS TX 75312 PEDIATRICIAN LOCUM STAFFING 102212 3 5530490 6281 475941 5536771 PATIENT REVENUE, NET 621110 9762830 9762830 340B PHARMACY REVENUE 621110 2331615 2331615 12094445 MISCELLANEOUS REVENUE 561499 761230 761230 761230 18392446 12094445 0 761230 4849 4849 776659 254035 522624 8174518 5797175 2377343 170852 141416 29436 2091493 1418238 673255 755097 512501 242596 240693 222919 17774 22018 22018 540 540 1065002 391962 673040 75229 46328 28901 117422 100054 17368 244972 226882 18090 635040 530512 104528 51837 32139 19698 46139 28606 17533 253007 253007 574540 574540 67146 44056 23090 MEDICAL SUPPLIES 1708369 1708369 BAD DEBT 159706 159706 EQUIP. MAINT. & REPAIRS 111508 90821 20687 MISCELLANEOUS EXPENSES 69740 40911 28829 108466 83170 25296 17524842 12662196 4862106 540 2889066 3583796 1353177 824302 142750 0 815813 1587647 15960 171597 174778 15507299 2548559 11729944 12958740 17102347 19145223 1978178 1689495 7067 3211 9676051 11143862 11661296 12836568 X 5441051 6308655 5441051 6308655 17102347 19145223 867604 0 X 0 1 X 1 1 1 X 3602844 3969709 7476731 6046045 5536771 26632100 3602844 3969709 7476731 6046045 5536771 26632100 26632100 353766 297098 352639 457449 761230 2222182 28854282 54142859 0.92300 0.92870 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1027334 1027334 10292467 413347 9879120 1086477 1086477 1946042 1843827 102215 1154979 291385 863594 12958740 X 18232740 0 18232740 159706 159706 18392446 17365136 0 17365136 159706 159706 17524842 PART X, LINE 2: THE CENTER HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE CENTER'S TAX POSITIONS AND CONCLUDED THAT THE CENTER HAD TAKEN NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 159,706. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 159,706. X X 0 0 X X X X 0 0 0 0 0 0 0 0 0 ADAM WEAVER DENTAL CHIEF 207610 0 2000 0 0 0 22596 0 0 0 232206 0 0 0 KEVIN KNEPPER CEO 198999 0 2000 0 0 0 27000 0 0 0 227999 0 0 0 BEN STOCKTON FAMILY PRACTICE PHYSICIAN 193434 0 2000 0 0 0 20451 0 6160 0 222045 0 0 0 GEORGE DELAND PEDIATRICIAN 205438 0 2000 0 0 0 13048 0 0 0 220486 0 0 0 NICK MILLER DENTIST 193111 0 2000 0 0 0 8411 0 6000 0 209522 0 0 0 FELICIA LUCAS FAMILY PRACTICE PHYSICIAN 191752 0 2000 0 0 0 7838 0 2210 0 203800 0 0 0 HAILEY ROSE PEDIATRICIAN 184398 0 2000 0 0 0 8112 0 5900 0 200410 0 0 0 AMBER VILLELLI COO 143078 0 2000 0 0 0 11664 0 0 0 156742 0 0 0 PART I, LINE 1A THE ORGANIZATION RENTS A CONDOMINIUM FROM GEORGE DELAND FOR A PEDIATRIC RESIDENT TO STAY AT. THE MONTHLY RENT PAYMENTS OF $1,150 ARE BELOW FAIR MARKET VALUE. THE ORGANIZATION OFFERS TO PAY $10 PER MONTH FOR ANY EMPLOYEE WITH A GYM MEMBERSHIP. X 5136 475941 INVOICE PRICE 0 0 0 0 PART I, COLUMN (B): THE NUMBER REPORTED IN COLUMN B REPRESENTS THE NUMBER OF DONATED ITEMS RECEIVED DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS CHAIRED BY THE BOARD CHAIR AND IS RESPONSIBLE FOR MAKING RECOMMENDATIONS ON PROGRAMMATIC AND POLICY ISSUES AT TIMES WHEN THE BOARD IS UNABLE TO MEET. ALL SUCH DECISIONS MUST BE RATIFIED BY THE FULL BOARD AT ITS NEXT MEETING. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CFO AND CEO, THEN PRESENTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE COMPLETED AND REVIEWED ANNUALLY FOR THE BOARD OF DIRECTORS AND KEY EMPLOYEEES. EACH INDIVIDUAL IS REQUIRED TO DISCLOSE ANY PERSONAL INTEREST WHICH THEY MAY HAVE IN ANY MATTER PENDING BEFORE THE ORGANIZATION AND REFRAINS FROM PARTICIPATION IN ANY DECISION ON SUCH MATTER. SUCH REFRAINING MAY TAKE THE FORM OF SIMPLE DISCLOSURE, LEAVING THE ROOM DURING DISCUSSION, NOT PARTICIPATING IN THE DISCUSSION, OR RECUSING ONESELF FROM THE ISSUE ALTOGETHER. FORM 990, PART VI, SECTION B, LINE 15 THE KANIKSU COMMUNITY HEALTH COMPENSATION MODEL - AS APPROVED BY THE BOARD OF DIRECTORS (BOD) - IS A COMPENSATION SCHEDULE BASED ON THE MOST RECENT NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTER (NACHC) REGION 10 (WASHINGTON, OREGON, IDAHO) COMPENSATION SURVEY BASED ON SIZE OF THE ORGANIZATION - ANNUAL REVENUES, SCOPE OF RESPONSIBILITY, YEARS OF EXPERIENCE AND EDUCATIONAL DEGREES, CERTIFICATIONS, ETC. ALL JOB CATEGORIES (INCLUDING CEO, OTHER OFFICERS AND KEY EMPLOYEES, ALL CLINICAL PROVIDERS AND ALL STAFF) HAVE AN ASSOCIATED COMPENSATION MODEL - THIS APPROACH HAS BEEN APPROVED BY THE BOD. THIS IS USED FOR ALL NEW HIRES AND IS EVALUATED ANNUALLY TO BE SURE THAT THERE IS INTERNAL EQUITY AMONG EMPLOYEES, ETC. THIS COMPENSATION MODEL IS ADJUSTED ANNUALLY BASED ON THE MOST RECENT NACHC DATA - RANGES OF SALARY ARE REVIEWED. IT IS THE GOAL OF KCH TO BE IN THE MEDIAN RANGE OF THE COMPENSATION MODEL - THIS APPROACH HAS BEEN APPROVED BY THE BOD. ANY ADJUSTMENTS MADE TO CURRENT EMPLOYEES ARE BASED ON AVAILABILITY OF BUDGET AS APPROVED BY THE BOD AND ARE DETERMINED BY "RANGE MOVEMENT" FOR STAFF POSITIONS AND FOR MAINTAINING COMPETITIVE RECRUITMENT AND RETENTION FOR PROVIDERS AS COMPARED TO THE OTHER COMMUNITY HEALTH CENTERS IN IDAHO AND IN REGION 10. DECISIONS ARE MADE BY THOSE WITHOUT CONFLICT AND THE DECISIONS ARE DOCUMENTED. THIS PROCESS WAS LAST COMPLETED IN 2019 FOR THE CEO AND 2021 FOR THE REST OF THE OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE CONFLICT OF INTEREST POLICY OR GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE FEDERAL AUDIT CLEARINGHOUSE WEBSITE.