2017-11-08T10:30:22-06:00 2016-12-31 461497033 EKS&H LLLP 8181 E TUFTS AVENUE SUITE 600 DENVER CO 802372579 990 2016-01-01 840765729 ROCKY MOUNTAIN HEALTH CARE SERVICES ROCK 7194668777 310 SOUTH 14TH STREET COLORADO SPRINGS CO 80904 TAMRIN APAYDIN CFO 7194668777 2017-11-07 1 DORI J EGGETT P00645252 3037409400 2016 2022-09-23 18:48:47Z TAMRIN APAYDIN 310 SOUTH 14TH STREET COLORADO SPRINGS CO 80904 39239321 0 X WWW.RMHCARE.ORG X 1978 CO SEE SCHEDULE OIMPROVING LIVES, OPTIMIZING WELLNESS, AND PROMOTING INDEPENDENCE FOR ELDERLY AND ADULTS WITH BRAIN INJURIES. 11 11 352 13 154031 133399 195825 153969 26951019 38188871 37154 -194333 162655 281597 27346653 38430104 0 0 0 0 10228362 12368286 37000 3000 257003 15177444 22107775 25442806 34479061 1903847 3951043 22958925 26126901 13668244 12885177 9290681 13241724 X IMPROVING LIVES, OPTIMIZING WELLNESS, AND PROMOTING INDEPENDENCE FOR ELDERLY AND ADULTS WITH BRAIN INJURIES. 0 0 26744372 33121692 THE PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY (PACE) IS A MANAGED CARE PROGRAM THAT COMBINES REIMBURSMENT FROM MEDICARE AND MEDICAID ON A PER MEMBER PER MONTH BASIS. THE PACE PROGRAM IS RESPONSIBLE FOR EVERY LEVEL OF THE FRAIL ELDERLY PARTICIPANTS' CARE FROM IN-HOME CARE TO HOSPITALIZATION. PACE ELIMINATES FRAGMENTATION AND ACCESS CONFUSION AND GREATLY IMPROVES QUALITY OF CARE PROVIDED TO THIS POPULATION. ALL TREATMENT IS PROVIDED BY AN INTERDISCIPLINARY TEAM CONSISTING OF MEDICAL, SOCIAL, SPIRITUAL, AND TRANSPORTATION STAFF. IN 2016, THE PACE PROGRAM PROVIDED 4,668 MEMBER MONTHS OF SERVICE TO 436 INDIVIDUAL PARTICIPANTS. 3949475 4552109 THE ROCKY MOUNTAIN BRAINCARE PROGRAM OFFERS FOUR RESIDENTIAL FACILITIES, A STRUCTURED DAY TREATMENT PROGRAM, INDIVIDUAL AND GROUP COUNSELING, AND INDIVIDUAL LIVING SKILLS TRAINING AT HOME AND IN THE COMMUNITY FOR INDIVIDUALS WHO HAVE INCURRED A BRAIN INJURY. THESE PROGRAMS PROVIDE AN ADAPTIVE ENVIRONMENT IN WHICH CLIENTS RELEARN SKILLS OF DAILY LIVING, SOCIAL INTERACTION, AND COGNITIVE FUNCTIONING LOST DUE TO BRAIN INJURIES. RMHCS IS THE ONLY RESIDENTIAL TREATMENT FACILITY FOR BRAIN INJURED INDIVIDUALS IN EL PASO COUNTY AND THE ONLY POST-HOSPITALIZATION FACILITY FOR THE BRAIN INJURED IN COLORADO. TREATMENT PLANS ARE INDIVIDUALIZED TO SPECIFIC CLIENT CARE NEEDS. ONE HUNDRED CLIENTS WERE SERVED BY THIS PROGRAM IN 2016. 1517899 3780 HEALTHRIDE PROVIDES TRANSPORTATION FOR RMHCS'S BRAINCARE CLIENTS AND PACE PARTICIPANTS AS WELL AS THE PARTICIPANTS OF OTHER ORGANIZATIONS SERVING SIMILAR POPULATIONS. IN 2016, HEALTHRIDE PROVIDED OVER 64,000 RIDES. 0 511290 SUPPORTIVE SERVICES PROVIDED FOR RMOLTC AND VARIOUS OTHER PROGRAM SUPPORTIVE SERVICES. 0 511290 32211746 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 170 0 1 352 1 1 1 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 0 0 X TAMRIN APAYDIN 7194668777 310 S 14TH STREET COLORADO SPRINGS CO 80904 BILL LEVIS BOARD CHAIR 10.00 X X 0 0 0 CAROLYN PACE BOARD MEMBER AT LARGE 1.00 X 0 0 0 DAN O'REAR BOARD TREASURER (PART YEAR) 1.00 X X 0 0 0 ED SMITH BOARD VICE-CHAIR 5.00 X X 0 0 0 JOHN BEAVERS BOARD MEMBER AT LARGE 1.00 X 0 0 0 MARNEL MOLA BOARD MEMBER AT LARGE (PART YEAR) 1.00 X 0 0 0 MCDENNIS THOMAS BOARD MEMBER AT LARGE (PART YEAR) 1.00 X 0 0 0 MELISSA KERR BOARD MEMBER AT LARGE 1.00 1.00 X 0 0 0 RALPH ZIMMERMAN BOARD MEMBER AT LARGE (PART YEAR) 1.00 X 0 0 0 ROBIN THORNE BOARD SECRETARY 2.00 1.00 X X 0 0 0 ROBYN FUHRMAN BOARD TREASURER (PART YEAR) 2.00 X X 0 0 0 SCOTT BOND BOARD MEMBER AT LARGE (PART YEAR) 1.00 X 0 0 0 SHIRLEY STEWART BOARD MEMBER AT LARGE 1.00 X 0 0 0 THOMAS REITER PRESIDENT & CEO 36.00 4.00 X 149221 0 32045 TAMRIN APAYDIN CHIEF FINANCIAL OFFICER 36.00 4.00 X 122342 0 24696 WANDA JONES VP OPERATIONS 40.00 X 98799 0 14426 JUSTIN LEWIS VP ORGANIZATIONAL DEVELOPMENT 40.00 X 99154 0 18315 CHRISTOPHER RUSKEY CHIEF MEDICAL OFFICER (PART YEAR) 40.00 X 166493 0 2387 SCOT SICKBERT PACE PHYSICIAN 40.00 X 223054 0 26536 ARLETTE KENNEDY PACE PHYSICAL THERAPIST 40.00 X 101165 0 1653 960228 0 120058 5 0 1 0 KMTSJ INC (PHARMASTAR LLC) PO BOX 3217 EAU CLAIRE WI 54702 PHARMACY MGMT/PRESCRIPTIONS 5314173 MEMORIAL HEALTH SYSTEM 1400 E BOULDER STREET COLORADO SPRINGS CO 809095533 INPATIENT/OUTPATIENT/ER 1534392 PENROSE ST FRANCIS PO BOX 910506 DENVER CO 802910506 INPATIENT/OUTPATIENT/ER 1271337 SUNNY VISTA LIVING CENTER 2445 E CACHE LA POUDRE STREET COLORADO SPRINGS CO 80909 SKILLED NURSING FACILITY 1074314 EMERITUS PROPERTIES XVI INC (BROOKDAL 6737 W WASHINGTON STREET SUITE 23 MILWAUKEE WI 53214 ASSISTED LIVING/MEMORY CARE 609370 31 715 37442 104000 11812 4412 153969 HEALTH CARE SERVICES 623990 37764896 37764896 RMOLTC 531110 410885 410885 PROGRAM RENTAL INCOME 531120 9310 9310 HEALTHRIDE 900099 3780 3780 38188871 707 707 340818 214238 126580 126580 105883 20697 355103 550143 -195040 -195040 33044 -228084 53000 37442 25828 27172 27172 11668 19008 -7340 -7340 CATERING 722320 14564 14564 LAUNDRY 812300 540 540 120081 120081 135185 38430104 38188871 154031 -66767 727877 168880 558997 9628160 8954769 489516 183875 206842 188857 14620 3365 1011321 972417 13191 25713 794086 700647 78987 14452 44596 44596 61253 61253 10244 10244 3000 3000 389068 315357 72437 1274 125786 111295 56 14435 76248 51425 24594 229 438489 359316 75737 3436 611038 579284 29210 2544 97707 86916 10791 62546 49333 13213 178308 117307 60286 715 740298 438041 302216 41 281347 231062 50285 CLIENT HEALTH CARE SERV 17631423 17625321 5801 301 VEHICLE AND EQUIPMENT 612370 579500 31493 1377 STAFF DEVELOPMENT 232524 193918 36963 1643 UBIT 17986 0 17986 0 496544 477857 18084 603 34479061 32211746 2010312 257003 4164115 7781636 0 40923 2854850 2966219 335328 389780 18283240 3357563 15604632 14925677 0 22666 22958925 26126901 3696227 2669503 0 31473 7794039 7069088 2177978 3115113 13668244 12885177 X 9290681 13241724 9290681 13241724 22958925 26126901 3951043 0 X 0 1 X 1 1 1 X 233466 275315 72569 195825 153969 931144 233466 275315 72569 195825 153969 931144 64346 866798 9270 109503 320978 4905 21404 466060 84762 92066 154031 330859 34771 41979 79456 84000 173081 413287 2141350 120643107 0.40480 0.41660 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2012 AMOUNT: $ 34,771. 2013 AMOUNT: $ 41,979. 2014 AMOUNT: $ 79,456. 2015 AMOUNT: $ 84,000. 2016 AMOUNT: $ 173,081. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10244 10244 34684823 34695067 1000000 250000 0 0 950000 1000000 1000000 1000000 3950000 5925000 5000 5000 5000 10244 25244 237500 250000 250000 250000 987500 1481250 616463 616463 15381619 2066501 13315118 1652056 850341 801715 633102 440721 192381 14925677 PACE MEDICAL LIABILITIES 3115113 3115113 X 38710792 21614 259074 280688 38430104 0 38430104 34759749 21614 259074 280688 34479061 0 34479061 PART X, LINE 2: THE ORGANIZATION APPLIES A MORE-LIKELY-THAN-NOT MEASUREMENT METHODOLOGY TO REFLECT THE FINANCIAL STATEMENT IMPACT OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. AFTER EVALUATING THE TAX POSITIONS TAKEN, NONE ARE CONSIDERED TO BE UNCERTAIN; THEREFORE, NO AMOUNTS HAVE BEEN RECOGNIZED AS OF DECEMBER 31, 2016 AND 2015. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 214,238. COST OF GOODS SOLD 19,008. FUNDRAISING EVENT EXPENSE 25,828. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 214,238. FUNDRAISING EVENT EXPENSE 25,828. CAFE CART EXPENSES 19,008. CHEF SHOWCASE 89954 36954 53000 9191 11072 4220 YARD SALE 488 488 1345 90442 37442 53000 9191 11072 5565 25828 27172 X X X X 0 0 0 0 0 0 0 0 0 THOMAS REITER PRESIDENT & CEO 144789 0 4290 0 142 0 6723 0 25322 0 181266 0 0 0 CHRISTOPHER RUSKEY CHIEF MEDICAL OFFICER (PART YEAR) 166392 0 0 0 101 0 1286 0 1101 0 168880 0 0 0 SCOT SICKBERT PACE PHYSICIAN 222363 0 295 0 396 0 7950 0 18586 0 249590 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THERE IS AN EXECUTIVE COMMITTEE MADE UP OF THE BOARD CHAIR, VICE CHAIR, TREASURER, AND SECRETARY. EACH OF THESE MEMBERS SERVE ON THE GOVERNING BODY OF THE ORGANIZATION AS WELL. THE EXECUTIVE COMMITTEE HAS THE POWER TO ACT ON BEHALF OF THE BOARD OF DIRECTORS ON ROUTINE MATTERS THAT ARISE BETWEEN REGULAR BOARD MEETINGS AND IN URGENT SITUATIONS THAT CANNOT WAIT FOR THE NEXT FULL BOARD MEETINGS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT CPA FIRM, REVIEWED IN DETAIL BY THE BOARD AUDIT AND FINANCE COMMITTEE, AND THEN EMAILED TO THE FULL BOARD FOR REVIEW AND COMMENTS BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES COMPLETE A STATEMENT REGARDING CONFLICTS OF INTEREST ANNUALLY. THESE STATEMENTS ARE REVIEWED BY THE APPROPRIATE SUPERVISOR OR BOARD PRESIDENT. ANY POTENTIAL CONFLICTS OF INTEREST ARE RESOLVED USING PROCESSES DOCUMENTED IN THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS THE CEO ANNUALLY AND SETS COMPENSATION UTILIZING THE ORGANIZATION'S COMPENSATION PLAN ESTABLISHED USING CURRENT MARKET COMPENSATION SURVEY DATA. THE COMPENSATION AMOUNT AND APPROVAL ARE DOCUMENTED IN THE BOARD MINUTES. THE CEO SETS THE OTHER MANAGEMENT SALARIES ALSO UTILIZING THE ORGANIZATION'S COMPENSATION PLAN AND CURRENT COMPENSATION SURVEY DATA. AN OUTSIDE CONSULTANT WAS HIRED TO CREATE THE COMPENSATION PLAN BASED ON NATIONAL MARKET SURVEY DATA. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST PLICY, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE UPON REQUEST. ROCKY MOUNTAIN BRAIN INJURY SERVICES LLC 310 S 14TH STREET COLORADO SPRINGS CO 80904 263739252 NONE CO 0 0 ROCKY MOUNTAIN HEALTH CARE SERVICES HEALTHRIDE LLC 310 S 14TH STREET COLORADO SPRINGS CO 80904 465153888 PROVIDES TRANSPORTATION SERVICES TO RMHCS CLIENTS & PATIENTS CO 20682 192880 ROCKY MOUNTAIN HEALTH CARE SERVICES ROCKY MOUNTAIN OPTIONS FOR LONG TERM CARE 310 S 14TH STREET COLORADO SPRINGS CO 80904 743037370 MEDICAID SEP CASE MANAGEMENT CO 501(C)(3) LINE 12B, II N/A 0 ROCKY MOUNTAIN PACE LLC 310 S 14TH STREET COLORADO SPRINGS CO 80904 263526736 NONE CO 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0