2024-11-11T10:43:41-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2023-01-01 030445789 NATIVE AMERICAN COMMUNITY CLINIC NATI 6128728086 1213 E FRANKLIN AVENUE MINNEAPOLIS MN 554042923 DR ANTONY STATELY CEO 6128728086 2024-11-07 1 0 RYAN ENGEBRETSON P01585625 6123764500 2024-11-07 2023 2024-10-15 13:58:12Z DR ANTONY STATELY 1213 E FRANKLIN AVENUE MINNEAPOLIS MN 554042923 18551119 0 X WWW.NACC-HEALTHCARE.ORG X 2002 MN PROMOTE WELLNESS OF BODY, MIND & SPIRIT & REGULAR HEALTH MAINTENANCE IN NATIVE AMERICAN FAMILIES. 12 12 142 19 0 0 7288913 10000663 6000868 8507001 11124 43455 0 0 13300905 18551119 0 0 0 0 8796190 10260270 0 129050 129050 3923821 7400969 12720011 17790289 580894 760830 11559278 12056178 2261605 1997675 9297673 10058503 TO PROMOTE WELLNESS AND REGULAR HEALTH MAINTENANCE IN NATIVE AMERICAN FAMILIES, TO DECREASE HEALTH DISPARITY IN THE NATIVE AMERICANS IN THE METRO AREA, AND TO PROVIDE ACCESS TO QUALITY CARE REGARDLESS OF ABILITY TO PAY. 0 0 12724457 0 8406308 PROVIDES MEDICAL, DENTAL, BEHAVIORAL HEALTH AND CHEMICAL HEALTH SERVICES TO NATIVE AMERICAN FAMILIES AND PATIENTS. THE ORGANIZATION HAD 24,019 VISITS DURING 2023. IN ADDITION THE ORGANIZATION PROVIDES CARE TO PATIENTS, WHO MEET CERTAIN CRITERIA UNDER THE ORGANIZATIONS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE ORGANIZATION BELIEVES THE UNDERSERVED ARE THOSE PERSONS WHO ARE UNABLE THROUGH PRIVATE RESOURCES, EMPLOYER SUPPORT OR PUBLIC AID TO PROVIDE PAYMENT FOR HEALTH CARE SERVICES OR THOSE UNABLE TO GAIN ACCESS TO HEALTH RELATED CARE BECAUSE OF LIMITED RESOURCES, INADEQUATE EDUCATION, OR DISCRIMINATION. BECAUSE THE ORGANIZATION DOES NOT PURSUE COLLECTIONS OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS REVENUE. 12724457 1 1 0 0 0 0 0 0 0 0 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 1 0 0 0 0 0 0 0 0 1 39 0 1 142 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 0 1 1 1 1 1 1 1 1 0 MN X JENNY SINGH 6128435995 1213 EAST FRANKLIN AVENUE MINNEAPOLIS MN 55404 B DON CROFUT BOARD CHAIR 0.50 X X 0 0 0 STEPHANIE GRAVES BOARD VICE CHAIR 0.50 X X 0 0 0 JOE BEAULIEU BOARD TREASURER 0.50 X X 0 0 0 CHARLA SHEFFIELD BOARD SECRETARY 0.50 X X 0 0 0 LYLE IRON MOCCASIN BOARD MEMBER 0.50 X 0 0 0 ROBERT BLAKE BOARD MEMBER 0.50 X 0 0 0 RICHARD MASUR BOARD MEMBER 0.50 X 0 0 0 LAUREN GILCHRIST BOARD MEMBER 0.50 X 0 0 0 NICHOLE SUBOLA BOARD MEMBER 0.50 X 0 0 0 AARON ROBINSON BOARD MEMBER 0.50 X 0 0 0 COLLEEN MCDONALD BOARD MEMBER 0.60 X 0 0 0 KARINA FOREST BOARD MEMBER 0.50 X 0 0 0 DR KARIE RABIE CMO 40.00 X 220594 0 57502 DR ANTONY STATELY CEO 40.00 X 222231 0 59604 GREGG HARRISON COO 40.00 X 127384 0 44444 JENEATTA SINGH FINANCE OFFICER 40.00 X 136130 0 15157 SHANNON KLINGELHULTZ CIO 40.00 X 109546 0 52205 GAIL MASON BEHAVIORAL HEALTH DIRECTOR 40.00 X 115949 0 319 CHRISTINE SINGER MEDICAL DIRECTOR 40.00 X 147537 0 40361 EMILY PIETIG DENTAL DIRECTOR 40.00 X 176644 0 56043 VALERIE NORRIS PEDIATRICIAN 30.00 X 129384 0 13385 PHONG NGUYEN ADVANCED DENTAL THERAPIST 40.00 X 122969 0 20225 JACE GILBERTSON ASSOCIATE MEDICAL DIRECTOR OF QUAILITY 40.00 X 107700 0 20636 JODI BECKER ADVANCED DENTAL THERAPIST 40.00 X 103978 0 13325 1720046 0 393206 12 0 1 0 VISUALUTIONS 27440 MINTWOOD LANE SPRING TX 77379 FINANCIAL AND IT SOLUTIONS 238695 ALIA 1000 UNIVERSITY AVE W ST PAUL MN 55104 INNOVATION SERVICES 199373 BRIAN GORECKI REAL ESTATE CONSULTANT 2174 UPPER SAINT DENNIS ROAD ST PAUL MN 55115 REAL ESTATE CONSULTANT 165000 COLLAGE 708 15TH AVE NE MINNEAPOLIS MN 55413 ARCHITECT 164319 PERKINS AND WILL INC 410 NORTH MICHIGAN AVE SUITE 1600 CHICAGO IL 60611 ARCHITECT 151880 19 10085 6264266 3726312 211192 10000663 PATIENT REVENUES 621400 8406308 8406308 OTHER REVENUE 900099 100693 100693 8507001 43455 43455 0 10085 0 0 18551119 8406308 0 144148 X 931834 465917 465917 6935634 5337382 1598252 139490 100887 38603 1659662 1227746 431916 593650 436383 157267 26349 26349 49344 49344 38000 38000 129050 129050 4182577 2771225 1411352 47998 677 47321 157834 79804 78030 379184 234348 144836 2691 2691 223463 180533 42930 21451 13383 8068 12390 12390 625411 469058 156353 52886 717 52169 PROGRAM & LAB SUPPLIES 995177 995177 0 MISCELLANEOUS EXPENSE 281351 242516 38835 REPAIRS AND MAINTENANCE 200477 41674 158803 MN CARE TAX 81100 81100 23286 7930 15356 17790289 12724457 4936782 129050 2373726 2690125 1524230 1547268 334453 0 2340605 2918572 87733 48653 7985395 3191174 4794338 4794221 104193 57339 11559278 12056178 1017787 956581 532258 545031 368500 0 250000 450000 93060 46063 2261605 1997675 X 9297673 10058503 9297673 10058503 11559278 12056178 760830 0 X 0 1 X 1 1 1 X 3322817 5530356 11875208 7288913 10010254 38027548 3322817 5530356 11875208 7288913 10010254 38027548 1720426 36307122 8411 5111 7043 11124 43455 75144 38102692 25248875 0.95290 0.99880 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 38000 38000 0 PART II-B, LINE 1: LEGISLATIVE REPRESENTATION 2935000 2935000 1236529 752669 483860 2086719 1580144 506575 1727147 858361 868786 4794221 SHORT TERM LEASE LIABILITY 28876 LONG TERM LEASE LIABILITY 17187 46063 X 18551119 0 18551119 0 18551119 17790289 0 17790289 0 17790289 PART X, LINE 2: THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE FEDERAL INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX PROVISIONS. THE IMPLEMENTATION OF THE ACCOUNTING STANDARDS REGARDING UNCERTAIN TAX PROVISIONS HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. X X X 1 J MURPHY AND ASSOCIATES RAINMAKER LLC 1300 NE GODWARD ST SUITE 2625 MINNEAPOLIS MN 55413 CAPITAL CAMPAIGN 0 0 56550 -56550 FOX ADVNACEMENT 12141 131ST STREET CT S HASTINGS MN 55003 CAPITAL CAMPAIGN 0 0 72500 -72500 129050 -129050 MN X X X 0 0 0 0 0 0 0 0 0 DR ANTONY STATELY CEO 222231 0 0 0 0 0 11388 0 48216 0 281835 0 0 0 DR KARIE RABIE CMO 220594 0 0 0 0 0 5791 0 51711 0 278096 0 0 0 EMILY PIETIG DENTAL DIRECTOR 176644 0 0 0 0 0 8482 0 47561 0 232687 0 0 0 CHRISTINE SINGER MEDICAL DIRECTOR 147537 0 0 0 0 0 6191 0 34170 0 187898 0 0 0 GREGG HARRISON COO 127384 0 0 0 0 0 5925 0 38519 0 171828 0 0 0 SHANNON KLINGELHULTZ CIO 109546 0 0 0 0 0 5551 0 46654 0 161751 0 0 0 JENEATTA SINGH FINANCE OFFICER 136130 0 0 0 0 0 0 0 15157 0 151287 0 0 0 X 309 211192 FAIR MARKET VALUE 0 0 0 0 PART I, COLUMN (B): PART I REPORTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS COMPOSED OF THE OFFICERS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE AFFAIRS, DAY TO DAY OPERATIONS AND GENERAL BUSINESS OF THIS CORPORATION. THE EXECUTIVE COMMITTEE IS AT ALL TIMES SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD OF DIRECTORS AND PROVIDES REPORTS TO THE BOARD OF DIRECTORS AT ITS REGULAR MEETINGS AND AS THE BOARD OF DIRECTORS OTHERWISE DETERMINES. IF NO CEO IS EMPLOYED, THE EXECUTIVE COMMITTEE ASSUMES THE ROLES AND RESPONSIBILITIES OF THE CEO. FORM 990, PART VI, SECTION B, LINE 11B BOTH THE MANAGEMENT AND BOARD OF DIRECTORS OF NATIVE AMERICAN COMMUNITY CLINIC REVIEWED THE FORM 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS. IF A DIRECTOR HAS AN ACTUAL OR POTENTIAL CONFLICT, THEY ARE REQUIRED TO DISCLOSE THE MATERIAL FACTS TO THE BOARD OF DIRECTORS WHO DETERMINE IF A CONFLICT EXISTS. AN INTERESTED PERSON MAY NOT VOTE ON ANY MATTERS RELATED TO AN ACTUAL OR POTENTIAL CONFLICT. IN ADDITION, THE INTERESTED PERSON IS NOT COUNTED IN DETERMINING THE PRESENCE OF A QUORUM. THE MINUTES OF THE MEETING REFLECT THE DISCLOSURE MADE, THE INTERESTED PERSON'S ABSTENTION FROM VOTING, AND WHETHER A QUORUM WAS PRESENT. FORM 990, PART VI, SECTION B, LINE 15 FOR OFFICERS, KEY EMPLOYEES AND HIGHEST PAID INDIVIDUALS, COMPENSATION WAS DETERMINED BY RESEARCHING THE RANGE OF SALARIES FOR COMPARABLE POSITIONS IN SIMILAR CLINICAL SETTINGS. COMPENSATION WAS BASED ON THE AVERAGE IN EACH SALARY RANGE. SINCE NATIVE AMERICAN COMMUNITY CLINIC IS A NOT-FOR-PROFIT ORGANIZATION, PHYSICIANS' SALARIES ARE BELOW-MARKET, BUT ARE IN LINE WITH COMPARABLE POSITIONS IN SIMILAR ORGANIZATIONS. BOARD APPROVAL FOR ALL EMPLOYEES WAS BASED ON RESEARCH FINDINGS AND NATIVE AMERICAN COMMUNITY CLINIC BUDGET ALLOWANCE. THIS RESEARCH WAS LAST PERFORMED IN 2022. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,771,225. MANAGEMENT AND GENERAL EXPENSES 1,411,352. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,182,577.