2018-05-15T16:32:24-05:00 2017-11-30 410746749 CLIFTONLARSONALLEN LLP 20 E THOMAS RD STE 2300 PHOENIX AZ 85012 990 2016-12-01 860498020 MOUNTAIN PARK HEALTH CENTER MOUN 6023233344 3003 NORTH CENTRAL AVENUE NO 1600 PHOENIX AZ 85012 JOHN SWAGERT MD CEO 6023233344 2018-05-05 1 CHRISTINE M ABELL P00279655 6022662248 2016 2022-09-23 18:48:47Z X JOHN SWAGERT MD 3003 NORTH CENTRAL AVENUE NO 1600 PHOENIX AZ 85012 81689959 0 X WWW.MOUNTAINPARKHEALTH.ORG X 1984 AZ PROVIDE AFFORDABLE PRIMARY CARE TO THE NEEDY AND UNINSURED IN THE GREATER PHOENIX AREA. 17 17 976 357 0 0 17577421 18978625 59887651 59893647 67825 90862 1764382 2704020 79297279 81667154 0 689641 0 0 44764289 53113509 0 0 0 26737802 31193165 71502091 84996315 7795188 -3329161 77773908 87815705 32960176 46139655 44813732 41676050 X MOUNTAIN PARK SUSTAINS AND IMPROVES HEALTH BY PROVIDING AFFORDABLE PRIMARY CARE TO THE NEEDY AND UNINSURED IN THE GREATER PHOENIX AREA. OUR COMMITMENT TO THE COMMUNITY IS TO KEEP HEALTHCARE AFFORDABLE AND ACCESSIBLE. 1 0 67245266 689641 59893647 MOUNTAIN PARK HEALTH CENTER PROVIDES ENCOUNTERS TO UNINSURED PATIENTS IN CARRYING OUT ITS TAX-EXEMPT PURPOSE AS A PRIMARY CARE FACILITY. IN 1984, MOUNTAIN PARK HEALTH CENTER BEGAN SERVING THE COMMUNITY WITH ONE DOCTOR AND ONE CLINIC LOCATION. TODAY, OUR COMMUNITY HEALTH CENTER HAS EIGHT CLINICS IN DIVERSE NEIGHBORHOODS ACROSS THE VALLEY, INCLUDING PRIMARY MEDICAL, DENTAL, PHARMACEUTICAL, AND INTEGRATED HEALTH CARE. THE CENTER PROVIDED 378,601 MEDICAL, DENTAL, AND INTEGRATED HEALTH VISITS TO 86,678 PATIENTS DURING THE FISCAL YEAR ENDED NOVEMEBER 30, 2017. 67245266 1 1 0 1 0 0 0 0 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 50 0 976 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 AZ X LYNN SMITH 6023233344 3003 NORTH CENTRAL AVENUE NO 1600 PHOENIX AZ 85012 RICHARD SIEVER CHAIR 2.00 5.00 X X 0 0 0 KRISTIN GUBSER VICE CHAIR 2.00 0.00 X X 0 0 0 JARRET SHARP EDD TREASURER 2.00 0.00 X X 0 0 0 LINDA HUFF REDMAN IMMEDIATE PAST CHAIR 2.00 0.00 X 0 0 0 MOHAMED ADEN DIRECTOR 2.00 0.00 X 0 0 0 MOHAMED AHMAD DIRECTOR (THROUGH JUNE 2017) 2.00 0.00 X 0 0 0 KEVIN CAMBERG DIRECTOR 2.00 1.00 X 0 0 0 ANIELKA CONTRERAS DIRECTOR 2.00 0.00 X 0 0 0 SCOTT GORMAN MD DIRECTOR 2.00 0.00 X 0 0 0 ROGER GRANCORVITZ DIRECTOR 2.00 0.00 X 0 0 0 REV ARNOLD JACKSON DIRECTOR (THROUGH JAN 2017) 2.00 1.00 X 0 0 0 RITA KHALAF DIRECTOR 2.00 0.00 X 0 0 0 LINDA KNUTSON DIRECTOR 2.00 0.00 X 0 0 0 MARTIN PEREZ DIRECTOR 2.00 0.00 X 0 0 0 SIMAN QAASIM DIRECTOR 2.00 1.00 X 0 0 0 LORI ROBINSON DIRECTOR 2.00 4.00 X 0 0 0 KALEIGH SCHWALBE DIRECTOR (THROUGH JUNE 2017) 2.00 0.00 X 0 0 0 ANTHONY TREMONTO DIRECTOR 2.00 0.00 X 0 0 0 DARREN VINER DIRECTOR 2.00 0.00 X 0 0 0 JORDAN YOUNG DIRECTOR 2.00 0.00 X 0 0 0 JOHN SWAGERT MD CHIEF EXECUTIVE OFFICER 44.00 5.00 X 413060 0 17788 CHRIS HEWETT CHIEF FINANCIAL OFFICER 46.00 1.00 X 147052 0 8333 RACHEL LAMBERT CHIEF OPERATING OFFICER 50.00 0.00 X 173110 0 17363 ALANA PODWIKA RPH CHIEF INFORMATION OFFICER 50.00 0.00 X 157044 0 10401 DAVINDER SINGH MD CHIEF MEDICAL OFFICER 50.00 0.00 X 316063 0 19817 STELLA XENAKIS SR. GRANTS DIR. / COMPLIANCE OFFICER 50.00 0.00 X 126030 0 3731 NEIL TRACHTENBERG PHYSICIAN 50.00 0.00 X 266345 0 720 MOHAMMAD AHMAD PHYSICIAN 50.00 0.00 X 261440 0 15748 GEORGE DAVIDSON PHYSICIAN 50.00 0.00 X 255834 0 19830 DENISE GENTLES-FORD PHYSICIAN 50.00 0.00 X 230909 0 7089 JOHN HARPENAU PHYSICIAN 50.00 0.00 X 217523 0 18697 2564410 0 139517 65 0 1 0 COSMOPOLITAN MEDICAL COMMUNICATIONS 5665 W BEVERLY LANE GLENDALE AZ 85306 ANSWERING SERVICES 2773387 CONCORD GENERAL CONTRACTORS 4215 E MCDOWELL RD STE 201 MESA AZ 85215 CONSTRUCTION 1833273 SONORA QUEST LABS PO BOX 29661 DEPT 2059 PHOENIX AZ 85038 MEDICAL SERVICES 991991 ECLINICAL WORKS PO BOX 847950 BOSTON MA 022847950 PATIENT ACCOUNTING 805432 DOCTORS RESOURCE SPECIALIST LLC 2525 W BERYL AVENUE PHOENIX AZ 85021 PATIENT BILLING 692335 29 17852702 1125923 3870899 18978625 NET PATIENT REVENUE 621400 57146982 57146982 PHARMACY REVENUE 621400 2746665 2746665 59893647 96593 96593 150067 0 150067 150067 150067 17074 0 22805 17074 -22805 -5731 -5731 OTHER INCOME 621400 1292809 1292809 INCENTIVE INCOME 621400 844644 844644 MEANINGFUL USE REVENUE 621400 416500 416500 2553953 81667154 59893647 0 2794882 X 689641 689641 1409792 1127834 281958 43481942 36867148 6614794 409893 296132 113761 4695772 3912806 782966 3116110 2643894 472216 214180 214180 59900 59900 12079 12079 10282945 5639288 4643657 262144 262144 1235941 756688 479253 1413081 387018 1026063 4358380 3915653 442727 247691 172718 74973 149308 53668 95640 1023842 6 1023836 2492033 1838711 653322 175934 6692 169242 MEDICAL SUPPLIES 8346065 8341103 4962 MISCELLANEOUS EXPENSES 919642 596266 323376 84996315 67245266 17751049 0 17711274 13199289 408722 637693 877450 1266727 18189434 20027820 6240 51086 38755 653079 521294 61669246 13044432 36685601 48624814 3091053 3069341 57370 19231 18448 80738 354154 77773908 87815705 6243770 7631102 618095 782757 11146151 11720906 15339 9563 14880750 25995327 56071 0 32960176 46139655 X 44813732 41676050 44813732 41676050 77773908 87815705 -3329161 191479 0 X 0 1 X 1 1 1 X 14346205 14166057 17033386 17577421 18978625 82101694 14346205 14166057 17033386 17577421 18978625 82101694 82101694 104 16998 223056 300784 246660 787602 523222 672783 1987388 1567616 2553953 7304962 90194258 241164331 0.91030 0.93410 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME DEBT FORGIVENESS MEANINGFUL USE REVENUE INCENTIVE INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 195092 0 0 0 195092 0 PART II-B, LINE 1: MOUNTAIN PARK HEALTH CENTER MAKES CONTRIBUTIONS TO BUILDING HEALTHY COMMUNITIES AND THE ARIZONA ALLIANCE OF COMMUNITY CENTERS, A PORTION OF WHICH IS USED TO LOBBY ON BEHALF OF THEIR MEMBERS. 0 1 X 8632011 8632011 32974467 7460382 25514085 9283223 2031471 7251752 7363898 3552579 3811319 3415647 3415647 48624814 X 81741283 63663 646315 709978 81031305 12079 623770 635849 81667154 84553383 63663 623510 687173 83866210 12079 1118026 1130105 84996315 PART IV, LINE 2B: THE ORGANIZATION HOLDS SECURITY DEPOSITS FOR TENANTS WHO LEASE SPACE IN A BUILDING. THE FUNDS ARE HELD IN A BANK ACCOUNT UNTIL RETURNED TO THE TENANT. FUNDS ARE REFUNDED TO TENANTS UPON TERMINATION OF THE LEASE. PART X, LINE 2: THE HEALTH CENTER FOLLOWS GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS. THE HEALTH CENTER'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSETS 22,805. ELIMINATED INTERCOMPANY TRANSACTIONS 623,510. PART XI, LINE 4B - OTHER ADJUSTMENTS: MPHC TEMPE LLC REVENUES 623,510. BASELINE MEDICAL HOLDINGS LLC REVENUES 260. PART XII, LINE 2D - OTHER ADJUSTMENTS: ELIMINATED INTERCOMPANY TRANSACTIONS 623,510. PART XII, LINE 4B - OTHER ADJUSTMENTS: MPHC TEMPE LLC EXPENSES 535,523. BASELINE MEDICAL HOLDINGS LLC EXPENSES 82,955. TRANSFER OF NET ASSETS 499,548. 1 MAYA CINEMAS EDUCATION FUND 4730 SW MACADAM AVENUE SUITE 101 PORTLAND OR 97239 473931778 501(C)(3) 10000 TO FUND SCHOLARSHIPS BUILDING HEALTHY COMMUNITIES INC 3003 N CENTRAL AVENUE SUITE 1600 PHOENIX AZ 85012 815108903 501(C)(4) 180093 TO FUND STARTUP COSTS AND INITIAL OPERATIONS BASELINE MEDICAL PROPERTIES INC 3003 N CENTRAL AVENUE SUITE 1600 PHOENIX AZ 85012 821671826 501(C)(3) 499548 TO FUND STARTUP COSTS AND INITIAL OPERATIONS 2 1 PART I, LINE 2: BEFORE GIVING A CONTRIBUTION TO A LOCAL CHARITY, MOUNTAIN PARK HEALTH CENTER CONFIRMS THAT THE RECIPIENT IS A QUALIFIED CHARITY OR GOVERNMENT AGENCY. ASIDE FROM THIS CONFIRMATION, MOUNTAIN PARK HEALTH CENTER DOES NOT MONITOR FOR USE OF FUNDS. AS A CONDITION OF QUALIFYING FOR THE NEW MARKETS TAX CREDIT, MOUNTAIN PARK HEALTH CENTER GAVE A UNIQUE GRANT TO CHICAGO TITLE AGENCY TO FUND SCHOLARSHIPS. MOUNTAIN PARK HEALTH CENTER RECEIVES PERIODIC REPORTS ON THE USE OF FUNDS TO ENSURE THEY ARE USED APPROPRIATELY. X X X 0 0 0 0 0 0 0 0 0 JOHN SWAGERT MD CHIEF EXECUTIVE OFFICER 413060 0 0 0 0 0 5908 0 11880 0 430848 0 0 0 CHRIS HEWETT CHIEF FINANCIAL OFFICER 147052 0 0 0 0 0 0 0 8333 0 155385 0 0 0 RACHEL LAMBERT CHIEF OPERATING OFFICER 173110 0 0 0 0 0 5483 0 11880 0 190473 0 0 0 ALANA PODWIKA RPH CHIEF INFORMATION OFFICER 157044 0 0 0 0 0 2421 0 7980 0 167445 0 0 0 DAVINDER SINGH MD CHIEF MEDICAL OFFICER 316063 0 0 0 0 0 7937 0 11880 0 335880 0 0 0 NEIL TRACHTENBERG PHYSICIAN 266345 0 0 0 0 0 0 0 720 0 267065 0 0 0 MOHAMMAD AHMAD PHYSICIAN 261440 0 0 0 0 0 7228 0 8520 0 277188 0 0 0 GEORGE DAVIDSON PHYSICIAN 255834 0 0 0 0 0 7950 0 11880 0 275664 0 0 0 DENISE GENTLES-FORD PHYSICIAN 230909 0 0 0 0 0 6369 0 720 0 237998 0 0 0 JOHN HARPENAU PHYSICIAN 217523 0 0 0 0 0 6817 0 11880 0 236220 0 0 0 A ARIZONA HEALTH FACILITIES AUTHORITY 860453292 2014-02-27 12225000 SEE PART VI 0 0 0 A 12225000 235913 7000000 4989087 2015 0 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 PART I, COLUMN F DESCRIPTION OF PURPOSE: TO FINANCE THE CONSTRUCTION, IMPROVEMENT AND EQUIPPING OF HEALTH CARE FACILITIES FOR USE BY THE BORROWER; TO REFINANCE CERTAIN OF THE BORROWER'S OUTSTANDING OBLIGATIONS FOR THE ACQUISITION AND CONSTRUCTION OF PRIOR HEALTH CARE FACILITIES AND OPERATING EXPENSES; AND TO PAY THE COSTS OF ISSUANCE OF THE SERIES 2014 BONDS. X 190 3865849 FAIR VALUE X MISCELLANEOUS 4 5050 FMV 0 0 1 0 FORM 990, PART III, LINE 2 DURING THE FISCAL YEAR, THE ORGANIZATION ADDED HIGH-RISK PREGNANCY SERVICES. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CONSISTS OF THE BOARD OFFICERS AND THE IMMEDIATE PAST CHAIR IF STILL ON THE BOARD. THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE THE POWERS OF THE BOARD BETWEEN MEETINGS OF THE BOARD, BUT SHALL NOT POSSESS ANY AUTHORITY OF THE BOARD PROHIBITED BY LAW. IN ADDITION, THE EXECUTIVE COMMITTEE MAY NOT (A) FIX THE COMPENSATION OF, OR FILL ANY VACANCY ON, THE BOARD OF DIRECTORS OR ANY OF ITS COMMITTEES, (B) ADOPT AMENDMENTS TO THE ARTICLES OF INCORPORATION OR TO THE BYLAWS, (C) AUTHORIZE DISTRIBUTIONS, OR (D) APPROVE A MERGER OF THE ORGANIZATION OR SALE OF SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE AND AUDIT COMMITTEES REVIEWED AND APPROVED THE FORM 990, THEN THE BOARD OF DIRECTORS APPROVED THE FORM 990 BEFORE IT WAS SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ANNUALLY REVIEW AND SIGN A CONFLICT OF INTEREST STATEMENT. POTENTIAL CONFLICTS ARE BROUGHT TO THE FULL BOARD FOR A DETERMINATION OF WHETHER A CONFLICT EXISTS. EMPLOYEES ARE REQUIRED TO ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT TO DISCLOSE POTENTIAL CONFLICTS. IF THE SITUATION IS UNCLEAR, THE CEO DETERMINES WHETHER A CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 SALARIES ARE DETERMINED BY A COMBINATION OF PERFORMANCE EFFECTIVENESS REVIEWS AND SALARY SURVEY DATA FOR COMPARABLE JOBS COMPILED BY AN INDEPENDENT FIRM. THE SALARIES OF THE CEO AND OTHER OFFICERS ARE SET AND REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS AND COMPARED TO SURVEY DATA FOR COMPARABLE JOBS. THE LAST COMPENSATION REVIEW OCCURRED IN 2017. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 5,543,162. MANAGEMENT AND GENERAL EXPENSES 4,292,010. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,835,172. OTHER SERVICES: PROGRAM SERVICE EXPENSES 96,126. MANAGEMENT AND GENERAL EXPENSES 351,647. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 447,773. MOUNTAIN PARK HEALTH CENTER TEMPE BUILDING LLC 3003 N CENTRAL AVENUE SUITE 1600 PHOENIX AZ 85012 813099857 HOLD PROPERTY AZ 623510 12625644 MOUNTAIN PARK HEALTH CENTER BASELINE MEDICAL HOLDINGS LLC 3003 N CENTRAL AVENUE SUITE 1600 PHOENIX AZ 85012 821688846 OPERATIONAL ARM OF BL 303 BLDG POINT OF BUSINESS AZ 260 13884710 MOUNTAIN PARK HEALTH CENTER MOUNTAIN PARK HEALTH CENTER FOUNDATION 3003 N CENTRAL AVENUE SUITE 1600 PHOENIX AZ 85012 205241918 SUPPORT MOUNTAIN PARK HEALTH CENTER AZ 501(C)(3) LINE 7 MOUNTAIN PARK HEALTH CENTER 1 BUILDING HEALTHY COMMUNITIES INC 3003 N CENTRAL AVENUE SUITE 1600 PHOENIX AZ 85012 815108903 ADVOCATE TO AZ FAMILIES TO HAVE QUALITY HEALTH CARE AZ 501(C)(4) MOUNTAIN PARK HEALTH CENTER 1 BASELINE MEDICAL PROPERTIES INC 3003 N CENTRAL AVENUE SUITE 1600 PHOENIX AZ 85012 821671826 NEW MARKETS TAX CREDIT AZ 501(C)(3) LINE 12A, I MOUNTAIN PARK HEALTH CENTER 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 BUILDING HEALTHY COMMUNITIES INC B 180093 CASH BASELINE MEDICAL PROPERTIES INC B 499548 CASH