DHHA OMC QALICB INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
DHHA OMC QALICB INC (EIN 84-3764289)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-03
IRS object ID
202103079349301500
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-11-03T09:42:18-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 South Tejon Suite 800AddressLine1Txt
CityColorado SpringsCityNm
State AbbreviationCOStateAbbreviationCd
ZIP809039848ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN843764289EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DHHA OMC QALICB INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% CHELSEA HELMKAMPInCareOfNm
Business Name ControlDHHABusinessNameControlTxt
Phone3036027044PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1777 BANNOCK STREET MAIL CODE 1925AddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80204ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCHELSEA HELMKAMPPersonNm
Person TitleCONTROLLERPersonTitleTxt
Phone3036027045PhoneNum
Signature2021-10-28SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstChelseaPersonFirstNm
Person LastHelmkampPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAdam R Smith CPAPreparerPersonNm
PTINP00958966PTIN
Phone7194714290PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Initial ReturnYes (X)InitialReturnInd
Principal OfficerSARA CARPENTERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1777 BANNOCK STREET MC 1925AddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80204ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,081,151GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2019FormationYr
Legal Domicile StateCOLegalDomicileStateCd
Activity Or MissionTHE ORGANIZATION WAS CREATED TO ASSIST THE DENVER HEALTH AND HOSPITAL AUTHORITY WITH FINANCING EQUIPMENT IN THE NEW OUTPATIENT MEDICAL CENTER IN DENVER, CO.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$837,597CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$205,283CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$38,271CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$0PYTotalRevenueAmt
CY Total Revenue$1,081,151CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$0PYOtherExpensesAmt
CY Other Expenses$534,796CYOtherExpensesAmt
PY Total Expenses$0PYTotalExpensesAmt
CY Total Expenses$534,796CYTotalExpensesAmt
PY Revenues Less Expenses$0PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$546,355CYRevenuesLessExpensesAmt
Total Assets BOY$0TotalAssetsBOYAmt
Total Assets EOY$19,329,468TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$18,783,113TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$0NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$546,355NetAssetsOrFundBalancesEOYAmt
MissionTHE ORGANIZATION WAS CREATED TO ASSIST THE DENVER HEALTH AND HOSPITAL AUTHORITY WITH FINANCING EQUIPMENT IN THE NEW OUTPATIENT MEDICAL CENTER IN DENVER, CO.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$534,796ExpenseAmt
Revenue$205,283RevenueAmt
DescASSISTANCE WITH FINANCING AND LEASING OF MEDICAL EQUIPMENT FOR THE OUTPATIENT MEDICAL CENTER IN DENVER, CO.Desc
Total Program Service Expenses$534,796TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCOStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCHELSEA HELMKAMPPersonNm
Phone3036027044PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1777 BANNOCK STREET MAIL CODE 1925AddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80204ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
PEG BURNETTE
DIRECTOR2.040.0Yes (X)$0$453,366$97,840
SCOTT HOYE
SECRETARY2.040.0Yes (X)$0$417,692$93,602
BRADFORD MEMBEL
DIRECTOR (PART YEAR)2.040.0$0$235,030$55,426Yes (X)
CHELSEA HELMKAMP
DIRECTOR2.040.0$0$143,114$43,905Yes (X)
FARAZ KHAN
VP/TREASURER2.040.0Yes (X)$0$146,047$10,652
REBECCA SUNSHINE DEWITT
DIRECTOR2.02.0$0$0$0Yes (X)
SARA CARPENTER
PRESIDENT/DIRECTOR2.02.0Yes (X)$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,395,249TotReportableCompRltdOrgAmt
Total Other Compensation$301,425TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$837,597RelatedOrganizationsAmt
All Other Contributions$0AllOtherContributionsAmt
Total Contributions$837,597TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescEquipment Lease Agreement DHHADesc
Business532420BusinessCd
Total Revenue Column$205,283TotalRevenueColumnAmt
Related Or Exempt Func Income$205,283RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$205,283TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,271TotalRevenueColumnAmt
Exclusion$38,271ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,081,151TotalRevenueColumnAmt
Related Or Exempt Func Income$205,283RelatedOrExemptFuncIncomeAmt
Exclusion$38,271ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$130,320TotalAmt
Program Services$130,320ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$77,265TotalAmt
Program Services$77,265ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$71,081TotalAmt
Program Services$71,081ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$176,894TotalAmt
Program Services$176,894ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$79,236TotalAmt
Program Services$79,236ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$534,796TotalAmt
Program Services$534,796ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$7,897,956EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,431,512LandBldgEquipCostOrOtherBssAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$11,431,512EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$19,329,468EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$18,705,848EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$77,265EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$18,783,113EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$546,355EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$546,355EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$19,329,468EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$546,355ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations2SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (2 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
DENVER HEALTH AND HOSPITAL AUTHORITY
8413232423Yes (true)$0$0
DENVER COMMUNITY HEALTH SERVICES
7424804847Yes (true)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total2SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt
Public Support CY5090.00000PublicSupportCY509Pct

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationYes (true)SuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART IV, LINE 2:FormAndLineReferenceDesc
ExplanationDHHA OMC QALICAB, INC. SUPPORTS DENVER HEALTH & HOSPITAL AUTHORITY, A GOVERNMENTAL HOSPITAL TAX EXEMPT AS A GOVERNMENTAL ORGANIZATION THAT WOULD QUALIFY AS A PUBLIC CHARITY AND TAX EXEMPT HOSPITAL UNDER INTERNAL REVENUE CODE SECTIONS 170(B)(1)(A)(III) OR 509(A)(2).ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,938,936OtherCostOrOtherBasisAmt
Book Value$5,938,936BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,492,576OtherCostOrOtherBasisAmt
Book Value$5,492,576BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,431,512TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO/FROM RELATED PARTYDesc
Amt$77,265Amt
FieldValueIRS element (for citing)
Total Liability$77,265TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$1,200,983TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$119,832DonatedServicesAndUseFcltsAmt
Revenue Not Reported$119,832RevenueNotReportedAmt
Revenue Subtotal$1,081,151RevenueSubtotalAmt
Total Revenue Per Form990$1,081,151TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$654,628TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$119,832DonatedServicesUseFcltsAmt
Expenses Not Reported$119,832ExpensesNotReportedAmt
Expenses Subtotal$534,796ExpensesSubtotalAmt
Total Expenses Per Form990$534,796TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART X, LINE 2FormAndLineReferenceDesc
ExplanationMANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
CHELSEA HELMKAMP
DIRECTOR$0$122,058$0$13,168$0$7,888$0$14,758$0$29,147$0$187,019
SCOTT HOYE
SECRETARY$285,430$78,174$54,088$80,395$13,207$511,294
FARAZ KHAN
VP/TREASURER$74,012$60,000$12,035$8,674$1,978$156,699
PEG BURNETTE
DIRECTOR$308,922$93,666$50,778$86,609$11,231$551,206
BRADFORD MEMBEL
DIRECTOR (PART YEAR)$158,466$29,764$46,800$19,364$36,062$290,456

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3COMPENSATION IS DETERMINED AND PAID BY A RELATED PARTY, DENVER HEALTH AND HOSPITAL AUTHORITY. PLEASE SEE SCHEDULE O, PART VI, LINE 15A AND 15B NARRATIVE FOR ESTABLISHING COMPENSATION FOR EXECUTIVES.
SCHEDULE J, PART I, LINE 7EXPLANATION FOR NON-FIXED PAYMENTS: THE FOLLOWING INDIVIDUALS LISTED ON 990 PART VII, SECTION A, WERE COMPENSATED BY DENVER HEALTH AND HOSPITAL AUTHORITY AND PARTICIPATED IN THE MANAGEMENT INCENTIVE PLAN (MIP). UNDER THIS PLAN, THESE INDIVIDUALS RECEIVED THE FOLLOWING PAYMENTS: *PEG BURNETTE - $93,666 *SCOTT HOYE - $78,174 *BRADFORD MEMBEL - $29,764 *CHELSEA HELMKAMP - $13,168

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2THE FOLLOWING DIRECTORS/OFFICERS HAVE A BUSINESS RELATIONSHIP THROUGH THEIR EMPLOYMENT AT DENVER HEALTH AND HOSPITAL AUTHORITY: SCOTT HOYE, PEG BURNETTE, BRADFORD MEMBEL, CHELSEA HELMKAMP, AND FARAZ KHAN.
FORM 990, PART VI, SECTION A, LINE 6, 7A & 7BTHE VOTING MEMBERS OF THE CORPORATION ARE DENVER HEALTH AND HOSPITAL AUTHORITY (AUTHORITY) AND DENVER COMMUNITY HEALTH SERVICES (DCHS). THE VOTING MEMBERS SHALL BE ENTITLED TO APPOINT DIRECTORS AND TAKE ACTION ON ANY OTHER MATTER REQUIRING MEMBERSHIP APPROVAL OR FOR WHICH MEMBERSHIP APPROVAL IS PERMITTED UNDER THE COLORADO REVISED NONPROFIT CORPORATION ACT, THE ARTICLES OF INCORPORATION OR THE BYLAWS. APPROVAL FROM THE VOTING MEMBERS MUST ALSO BE OBTAINED FOR THE FOLLOWING: 1) THE SALE, EXCHANGE OR OTHER DISPOSITION OR THE MORTGAGE OR ENCUMBRANCE, OF ANY SIGNIFICANT PORTION OF THE CORPORATION'S ASSETS, TO A PARTY OTHER THAN THE CORPORATION; 2) THE LEASE OF ANY SIGNIFICANT PORTION OF THE CORPORATION'S ASSETS, OTHER THAN TO THE CORPORATION; AND 3) ANY INVESTMENT OF FUNDS IN EXCESS OF $50,000 OTHER THAN IN ACCORDANCE WITH INVESTMENT POLICIES APPROVED BY THE SOLE MEMBER; AND 4) OTHER ACTIONS SPECIFICALLY LISTED IN THE BYLAWS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11BPRIOR TO FILING THE FORM 990, THE DRAFT RETURN, PREPARED BY AN EXTERNAL PARTY IS REVIEWED BY AUTHORITY ACCOUNTING MANAGERS AND PRESENTED TO THE ORGANIZATION'S BOARD OF DIRECTORS FOR REVIEW AND APPROVAL PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL EMPLOYEES OF THE AUTHORITY AND BOARD MEMBERS OF THE ORGANIZATION. AN ANNUAL REVIEW AND QUESTIONNAIRE IS COMPLETED BY THE AUTHORITY'S OFFICE OF COMPLIANCE, WITH RESULTS REPORTED ANNUALLY TO THE AUTHORITY'S BOARD OF DIRECTORS AND THE ORGANIZATION'S BOARD OF DIRECTORS. THE POLICY ALSO GIVES THE AUTHORITY'S COMPLIANCE COMMITTEE THE POWER TO DETERMINE IF AN INDIVIDUAL HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AND DETERMINES THE APPROPRIATE CORRECTIVE ACTION.
FORM 990, PART VI, SECTION B, LINE 15A & 15BCOMPENSATION IS DETERMINED AND PAID BY A RELATED PARTY, DENVER HEALTH & HOSPITAL AUTHORITY. FOR ALL AUTHORITY EMPLOYEES, THERE IS AN ANNUAL WAGE SURVEY THAT IS PERFORMED. THE AUTHORITY ADJUSTS NON-MEDICAL PROVIDER POSITIONS TO BE AT 50% OF THE METROPOLITAN AREA BENCHMARK FOR COMPARABLE POSITIONS. THIS WAGE SURVEY DETERMINES COMPENSATION OF THE VARIOUS POSITIONS, INCLUDING THE TOP MANAGEMENT POSITIONS OF THE AUTHORITY.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. THE POLICIES ARE MAINTAINED BY DENVER HEALTH AND HOSPITAL AUTHORITY.
FORM 990 PART IX LINE 11GDESCRIPTION:EQUIPMENT SERVICES PERFORMED TOTAL FEES:77265

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Denver Community Health Services
777 Bannock StDenverCO80204742480484ManagementCO501(c)(3)Line 7NAfalse
Denver Health & Hospital Authority
777 Bannock ST Mail Code 1925DenverCO80204841323242HospitalCOGOVERNMENTNAfalse
601 Broadway Inc
777 BANNOCK ST MAIL CODE 1925DenverCO80204474295757RentalCO501(c)(3)Line 7DHHAfalse
550 Acoma
777 BANNOCK ST MAIL CODE 1925DenverCO80204831723828FinancingCO501(c)(3)Line 10DHHAfalse
DHHA Southwest Clinic Inc
777 Bannock St Mail Code 1925DenverCO80204371764469FinancingCO501(c)(3)Line 12ADHHAfalse
Rocky Mountain Drug Safety
777 BANNOCK ST MAIL CODE 1925DENVERCO80204475158056Data AnalysisCO501(c)(3)Line 12ADHHAfalse
CANADIAN CONSUMER PRODUCT & PHARMACEUTIC
Pharmacy OpsRMDSfalse100 King St W First CanadaTorontoCAM5X 1ECA
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgYes (true)AssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
DENVER HEALTH AND HOSPITAL AUTHORITY
C$837,597BOOK/CASH VALUE
DENVER HEALTH AND HOSPITAL AUTHORITY
H$11,431,512BALANCE SHEET
DENVER HEALTH AND HOSPITAL AUTHORITY
J$205,283BOOK/CASH VALUE

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