2025-11-17T15:55:55-06:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2024-01-01 030445789 NATIVE AMERICAN COMMUNITY CLINIC NATI 6128728086 1213 E FRANKLIN AVENUE MINNEAPOLIS MN 554042923 DR ANTONY STATELY CEO 6128728086 2025-11-17 1 0 RYAN ENGEBRETSON P01585625 6123764500 2025-11-12 2024 2025-03-06 01:10:19Z DR ANTONY STATELY 1213 E FRANKLIN AVENUE MINNEAPOLIS MN 554042923 17637760 0 X WWW.NACC-HEALTHCARE.ORG X 2002 MN PROMOTE WELLNESS OF BODY, MIND & SPIRIT & REGULAR HEALTH MAINTENANCE IN NATIVE AMERICAN FAMILIES. 11 11 162 31 0 0 10000663 9816706 8507001 7681998 43455 44523 0 55162 18551119 17598389 0 0 0 0 10260270 11450359 129050 212809 212809 7400969 6658307 17790289 18321475 760830 -723086 12056178 15899880 1997675 6564463 10058503 9335417 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 12526348 0 7681998 PROVIDES MEDICAL, DENTAL, BEHAVIORAL HEALTH AND CHEMICAL HEALTH SERVICES TO NATIVE AMERICAN FAMILIES AND PATIENTS. THE ORGANIZATION HAD 15,535 VISITS DURING 2024. 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. 12526348 1 1 0 1 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 1 1 0 0 0 1 32 0 1 162 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X GREGG HARRISON 6128728086 1213 E FRANKLIN AVE MINNEAPOLIS MN 55404 STEPHANIE GRAVES BOARD CHAIR 0.50 0.00 X X 0 0 0 JOE BEAULIEU BOARD VICE CHAIR 0.50 0.00 X X 0 0 0 CHARLA SHEFFIELD BOARD SECRETARY 0.50 0.00 X X 0 0 0 COLLEEN MCDONALD BOARD TREASURER 0.60 0.00 X X 0 0 0 KARINA FOREST BOARD MEMBER 0.50 0.00 X 0 0 0 NICHOLE SUBOLA BOARD MEMBER 0.50 0.00 X 0 0 0 AARON ROBINSON BOARD MEMBER 0.50 0.00 X 0 0 0 RICHARD MASUR BOARD MEMBER 0.50 0.00 X 0 0 0 B DON CROFUT BOARD MEMBER 0.50 0.00 X 0 0 0 LAUREN GILCHRIST BOARD MEMBER 0.50 0.00 X 0 0 0 LYLE IRON MOCCASIN BOARD MEMBER 0.50 0.00 X 0 0 0 ROBERT BLAKE BOARD MEMBER 0.50 0.00 X 0 0 0 DR ANTONY STATELY CEO 40.00 0.50 X 264963 0 53382 DR KARIE RABIE CMO 40.00 0.00 X 241023 0 17605 GREGG HARRISON COO 40.00 0.50 X 165505 0 31798 CHRISTINE SINGER MEDICAL DIRECTOR 40.00 0.00 X 161387 0 32179 JENEATTA SINGH FINANCE OFFICER 40.00 0.00 X 151851 0 11117 SHANNON KLINGELHULTZ CIO 40.00 0.00 X 151851 0 39732 EMILY PIETIG DENTAL DIRECTOR 40.00 0.00 X 223477 0 44875 JACE GILBERTSON ASSOCIATE MEDICAL DIRECTOR OF QUAILITY 40.00 0.00 X 134548 0 15342 KRISTIN SARKILAHTI IT DIRECTOR 40.00 0.00 X 117000 0 2462 NICHOLAS DAVIES NURSE PRACTIONER 40.00 0.00 X 115377 0 7908 MARY RAUKAR PHYSICIAN 40.00 0.00 X 105981 0 10965 1832963 0 267365 12 0 1 0 RED LAKE BAND OF CHIPPEWA INDIANS 15484 MIGIZI DRIVE RED LAKE MN 56671 HEALTH SERVICES 899281 SOUTHSIDE HARM REDUCTION SERVICES 2214 11TH AVE SOUTH MINNEAPOLIS MN 55404 ADMINISTRATIVE AGENT 737332 COLLAGE ARCHITECTS 708 15TH AVE NE MINNEAPOLIS MN 55413 ARCHITECT 479924 OCHIN INC P O BOX 5426 PORTLAND OR 97228 EMR SOFTWARE 313060 VISUALUTIONS 27440 MINTWOOD LANE SPRING TX 77379 FINANCIAL AND IT SOLUTIONS 254088 17 40100 6531633 3244973 65805 9816706 PATIENT REVENUES 621400 7681998 7681998 7681998 44523 44523 0 40100 39371 -39371 -39371 OTHER REVENUE 900099 94533 94533 94533 17598389 7681998 0 99685 X 1322394 661197 661197 7644690 6051977 1592713 128927 107739 21188 1694099 1305984 388115 660249 495187 165062 33069 33069 81005 81005 42000 42000 212809 212809 3444661 1508625 1936036 106131 901 105230 154082 72725 81357 85168 49264 35904 298975 134253 164722 28577 27677 900 22988 19077 3911 15991 15991 709348 532011 177337 13319 13319 PROGRAM AND LAB SUPPLIE 1244840 1244840 BAD DEBT 120392 120392 REPAIRS AND MAINTENANCE 84933 37377 47556 MN CARE TAX 82047 82047 90781 19756 71025 18321475 12526348 5582318 212809 2690125 7359962 1547268 752902 2918572 2270856 48653 66197 9225290 3894562 4794221 5330728 57339 119235 12056178 15899880 956581 1030324 545031 840005 0 171271 450000 4500000 46063 22863 1997675 6564463 X 10058503 9335417 10058503 9335417 12056178 15899880 -723086 0 X X 0 1 X 1 1 1 X 5530356 11875208 7288913 10010254 9816706 44521437 5530356 11875208 7288913 10010254 9816706 44521437 2371217 42150220 5111 7043 11124 43455 44523 111256 94533 94533 44727226 30115444 0.94240 0.95290 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2024 AMOUNT: $ 94,533. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 42000 42000 0 PART II-B, LINE 1: NATIVE AMERICAN COMMUNITY CLINIC PAYS LEGISLATIVE REPRESENTATION TO MESSERLI & KRAMER. 2935000 2935000 1236529 994599 241930 2086719 1840340 246379 1542306 1059623 482683 1424736 1424736 5330728 SHORT TERM LEASE LIABILITY 6343 LONG TERM LEASE LIABILITY 16520 22863 X 17517368 39371 39371 17477997 120392 120392 17598389 18240454 39371 39371 18201083 120392 120392 18321475 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE 39,371. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 120,392. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE 39,371. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 120,392. X X X 1 J MURPHY AND ASSOCIATES RAINMAKER LLC 1300 NE GODWARD ST SUITE 2625 MINNEAPOLIS MN 55413 CAPITAL CAMPAIGN 0 0 212809 -212809 212809 -212809 MN SMALL DINNER 40100 40100 832 1500 29841 731 6467 40100 40100 832 1500 29841 731 6467 39371 -39371 X X X X X 1 0 0 0 0 0 0 0 0 DR ANTONY STATELY CEO 264963 0 0 0 0 0 11479 0 41903 0 318345 0 0 0 EMILY PIETIG DENTAL DIRECTOR 196477 0 0 0 27000 0 7859 0 37016 0 268352 0 0 0 DR KARIE RABIE CMO 241023 0 0 0 0 0 5788 0 11817 0 258628 0 0 0 GREGG HARRISON COO 165505 0 0 0 0 0 7236 0 24562 0 197303 0 0 0 CHRISTINE SINGER MEDICAL DIRECTOR 161387 0 0 0 0 0 7008 0 25171 0 193566 0 0 0 SHANNON KLINGELHULTZ CIO 151851 0 0 0 0 0 6581 0 33151 0 191583 0 0 0 JENEATTA SINGH FINANCE OFFICER 151851 0 0 0 0 0 6081 0 5036 0 162968 0 0 0 PART I, LINE 4A NATIVE AMERICAN COMMUNITY CLINIC PROVIDED DR. EMILY PIETIG A $27,000 SEVERANCE PAYMENT AND COVERED THE EMPLOYER PORTION OF HEALTH AND DENTAL INSURANCE PREMIUMS THROUGH DECEMBER 31,2024 AS PART OF A SEPARATION AGREEMENT. X 54 65805 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. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2024. 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 1,508,625. MANAGEMENT AND GENERAL EXPENSES 1,936,036. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,444,661. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. NACC HOLDING COMPANY 1213 E FRANKLIN AVE MINNEAPOLIS MN 55404 332771933 HOLDING COMPANY FOR NMTC MN 501(C)(3) LINE 12A, I NATIVE AMERICAN COMMUNITY CLINIC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0