2024-03-26T10:41:55-05:00 2023-06-30 420941961 KING REINSCH PROSSER & CO LLP 522 4TH STREET SUITE 200 SIOUX CITY IA 51101 990 2022-07-01 426122297 SIOUXLAND MENTAL HEALTH SERVICES INC SIOU 7122523871 PO BOX 1917 SIOUX CITY IA 51102 SHEILA MARTIN CHIEF EXECUTIVE OFFICER 7122523871 2024-03-26 1 SHEILA MARTIN 999009999 1 REBECCA GEORGE P01228245 7122585550 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SHEILA MARTIN PO BOX 1917 SIOUX CITY IA 51102 10202574 0 X WWW.SIOUXLANDMENTALHEALTH.COM X 1969 IA TO PROVIDE MENTAL HEALTH SERVICES. 11 11 146 49 0 0 814741 1483650 7489970 8573507 -1444 78492 131272 54710 8434539 10190359 0 0 0 0 6995089 8175757 0 0 58729 1281455 1583210 8276544 9758967 157995 431392 5111280 9181221 912728 4551277 4198552 4629944 X TO PROVIDE A COMPREHENSIVE RANGE OF MENTAL HEALTH SERVICES FOR THE EVALUATION AND TREATMENT OF PEOPLE OF ALL AGES EXPERIENCING MENTAL ILLNESS, INDIVIDUAL OR FAMILY EMOTIONAL DISTRESS, AND OVERWHELMINGLY STRESSFUL CIRCUMSTANCES; TO PROVIDE EDUCATION SERVICES TO PREVENT OR EASE SUCH CONDITIONS; AND TO PROMOTE THE EMOTIONAL WELL-BEING OF PEOPLE IN WOODBURY COUNTY AND NEARBY COMMUNITIES. 0 0 1981045 2339639 THERAPY - TO PROVIDE THERAPY ON AN OUTPATIENT BASIS. 23,845 SESSIONS WERE HELD. 3,326 PATIENTS WERE SERVED. 1787884 1963007 PSYCHIATRY - TO EVALUATE CHILDREN AND ADULTS AS TO WHETHER TREATMENT SHOULD BE ON AN OUTPATIENT BASIS OR IF HOSPITALIZATION IS REQUIRED. 15,571 SESSIONS WERE HELD. 3,971 PATIENTS WERE SERVED. 1750811 4097279 COMMUNITY SUPPORT PROGRAM - TO PROVIDE SERVICES TO THE SEVERE MENTALLY HANDICAPPED AND DEVELOPMENTALLY DISABLED. 10,128 SESSIONS WERE HELD. 2,024 PATIENTS WERE SERVED. 147219 0 PROJECT COMPASS - TO PROVIDE JAIL DIVERSIONARY SERVICES. 550 SESSIONS WERE HELD. 1290533 173582 ASSESSMENT CENTER - TO PROVIDE 24/7 PROFESSIONAL HELP TO INDIVIDUALS EXPERIENCING AN INCREASE IN THE SEVERITY OF THEIR MENTAL HEALTH SYMPTOMS. 98 PATIENTS WERE SERVED. 570067 CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC EXPANSION - TO INCREASE ACCESS TO AND IMPROVE THE QUALITY OF COMMUNITY MENTAL AND SUBSTANCE USE DISORDER TREATMENT SERVICES THROUGH THE EXPANSION OF CCBHCS. 2007819 173582 7527559 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 29 0 1 146 1 0 0 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 0 1 1 1 1 1 0 0 0 X SHEILA MARTIN 7122523871 625 COURT STREET SIOUX CITY IA 51101 MARK MONSON DIRECTOR 1.00 X 0 0 0 DR RYAN MCKENNA PRESIDENT 1.00 X X 0 0 0 CHRISSIE YOUNG VICE-PRESIDENT 1.00 X X 0 0 0 NANCY KNUDSEN TREASURER 1.00 X X 0 0 0 DOUG HARROLD DIRECTOR 1.00 X 0 0 0 MIKE ESCH DIRECTOR 1.00 X 0 0 0 ZACH LEWIS DIRECTOR 1.00 X 0 0 0 WILL ANDERSON DIRECTOR 1.00 X 0 0 0 BEV ZENOR DIRECTOR 1.00 X 0 0 0 AMANDA BAKER SECRETARY 1.00 X X 0 0 0 SCOTT WILSON DIRECTOR 1.00 X 0 0 0 SHEILA MARTIN CHIEF EXECUTIVE OFFICER 37.50 X 199584 0 29054 RICARDO OSORIO NURSE PRACTITIONER 37.50 X 135750 0 17467 MELISSA KONKEN NURSE PRACTITIONER 37.50 X 125434 0 16448 LISA MEYER NURSE PRACTITIONER 40.00 X 119779 0 27821 DANIKA HANSEN NURSE PRACTITIONER 40.00 X 120702 0 24651 JOADA BEST NURSE PRACTITIONER 32.00 X 136688 0 735 837937 0 116176 6 0 1 0 INSYNC HEALTHCARE SOLUTIONS PO BOX 4577 CAROL STREAM IL 601974577 EMR PROVIDER 102411 1 30461 1266082 187107 1483650 FEES FROM INDIVIDUALS 624100 5936221 5936221 WOODBURY COUNTY 624100 2330298 2330298 OTHER REGIONS 624100 306988 306988 8573507 78492 78492 4406 30461 12215 -7809 -7809 MISCELLANEOUS REVENUE 624100 53913 53913 MEDICAL RECORDS 624100 8606 8606 62519 10190359 8573507 0 133202 246185 246185 6604167 5529914 1029783 44470 179968 149590 28961 1417 619496 518799 100332 365 525941 428960 93712 3269 1433 1433 26650 26650 196697 171885 24812 67635 21590 46045 188198 85338 99591 3269 258282 143363 113083 1836 14764 13655 1109 129720 124963 4531 226 143131 143131 304428 191884 110340 2204 62938 49998 12550 390 REPAIRS AND MAINTENANCE 142962 74427 67572 963 MISCELLANEOUS 19234 4688 14226 320 DUES 13937 5307 8630 MEAL PROGRAMS 9152 9152 4049 4046 3 9758967 7527559 2172679 58729 1990096 1609023 108584 194051 1039336 1401330 106325 122220 7375565 2270526 1866939 5105039 0 749558 5111280 9181221 716221 661024 3012 250 193495 3890003 912728 4551277 X 4130830 4450972 67722 178972 4198552 4629944 5111280 9181221 431392 0 X X 0 1 X 1 1 1 X 328496 776097 642685 645781 1434115 3827174 6508718 6232712 6513825 7489970 8573507 35318732 6837214 7008809 7156510 8135751 10007622 39145906 0 0 0 39145906 4098 6824 3788 2756 78492 95958 4098 6824 3788 2756 78492 95958 48067 236525 136438 131272 54710 607012 6889379 7252158 7296736 8269779 10140824 39848876 0.98240 0.98280 0.00240 0.00050 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2018 AMOUNT: $ 40,222. 2019 AMOUNT: $ 234,590. 2020 AMOUNT: $ 133,653. 2021 AMOUNT: $ 119,079. 2022 AMOUNT: $ 53,913. CONFERENCE - MEDICAL RECORDS - 2018 AMOUNT: $ 8,667. 2019 AMOUNT: $ 6,456. 2020 AMOUNT: $ 4,243. 2021 AMOUNT: $ 8,248. 2022 AMOUNT: $ 8,606. SPECIAL EVENTS - 2018 AMOUNT: $ -4,222. 2019 AMOUNT: $ -4,521. 2020 AMOUNT: $ -1,458. 2021 AMOUNT: $ 3,945. 2022 AMOUNT: $ -7,809. WITCC REVENUE - 2018 AMOUNT: $ 3,400. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 140903 140903 5680863 1358738 4322125 1553799 911788 642011 5105039 RESTRICTED CASH 749558 749558 10190359 0 10190359 0 10190359 9758967 0 9758967 0 9758967 GOLF EVENT 18171 13765 4406 600 3981 835 SCRAMBLE FOR SAM 16696 16696 0 4680 2119 34867 30461 4406 600 8661 2954 12215 -7809 X 0 0 0 0 0 0 0 0 0 SHEILA MARTIN CHIEF EXECUTIVE OFFICER 199584 0 0 0 0 0 11379 0 17675 0 228638 0 0 0 RICARDO OSORIO NURSE PRACTITIONER 135750 0 0 0 0 0 7636 0 9831 0 153217 0 0 0 A WOODBURY COUNTY IA 426005221 97907AAA5 2022-12-08 4000000 TO FINANCE THE COSTS OF ACQUIRING AND EQUIPPING A MENTAL HEALTH FACILITY. 0 0 0 A 100000 4000000 718909 119247 3512698 2024 0 0 1 1 A 0 0 0 0 0 0 0 0 0 KENDRA ARMISTEAD FAMILY RELATIONSHIP BETWEEN INDIVIDUAL AND BOARD MEMBER 22867 EMPLOYMENT 0 FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE COMMITTEE AND THE CHIEF EXECUTIVE OFFICER REVIEWED THE FORM 990 BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CHIEF EXECUTIVE OFFICER MONITORS THE STAFF AND BOARD'S COMPLIANCE WITH THIS POLICY. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.